Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 2011020392 | MO |
NPI | 1033406293 |
---|---|
Provider Name | Ms. Valerie Mae Monroy |
First Address | Independence, MO 64055-6975 |
Second Address | Independence, MO 64055-6975 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2011 |
Last Update Date | 14/11/2012 |