Individual
NICOLE YVONNE MONROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
6947 CRUMPLER BLVD STE 100, OLIVE BRANCH, MS 38654-1922
(662) 893-3300
(662) 893-3301
Mailing address
6947 CRUMPLER BLVD SUITE 100, OLIVE BRANCH, MS 38654-1922
(662) 893-3300
(662) 893-3301
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
647
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00802007
—
MS
01
—
2001
STATE LICENSE
TN
Enumeration date
12/19/2005
Last updated
03/07/2023
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