Individual
LICA MAE MONOBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
148 SKYVIEW DR, MT STERLING, KY 40353-1496
(859) 499-0717
Mailing address
148 SKYVIEW DR, MT STERLING, KY 40353-1496
(859) 499-0717
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2948
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100804250
—
KY
Enumeration date
04/05/2021
Last updated
04/01/2022
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