Individual
MS. MONIQUE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1825 E LINCOLN HWY, COATESVILLE, PA 19320-2407
(484) 619-4652
Mailing address
1825 E LINCOLN HWY, COATESVILLE, PA 19320-2407
(484) 619-4652
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN273670
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1116970150001
—
PA
Enumeration date
02/18/2022
Last updated
02/18/2022
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