Individual
CAROL MONROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2615 E 20TH ST, JOPLIN, MO 64804-1039
(417) 624-4701
(417) 624-9807
Mailing address
2615 E 20TH ST, JOPLIN, MO 64804-1039
(417) 624-4701
(417) 624-9807
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
107694
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100052650A
—
OK
05
—
100314760C
—
KS
01
—
126077
ANTHEM
MO
05
—
428635916
—
MO
01
—
P00248185
RR MEDICARE
—
Enumeration date
05/10/2006
Last updated
07/11/2023
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