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Individual

MONIQUE DAWN MALLOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
817 FRANKLIN ST, JOHNSTOWN, PA 15901-2800
(814) 535-5545
Mailing address
144 BOLTZ ST, JOHNSTOWN, PA 15902-1620
(814) 525-2176

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP025116
PA
363LF0000X
Family Nurse Practitioner
SP025116
PA

Other

Enumeration date
12/28/2021
Last updated
01/04/2026
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