Individual
MRS. STACY MONIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
400 HOBART ST, CADILLAC, MI 49601-2331
(231) 876-7200
Mailing address
3782 MOMENTUM PLACE, CHICAGO, IL 60689-0001
(231) 935-6080
(231) 935-6081
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704340839
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
4704340839
MI
363LG0600X
Gerontology Nurse Practitioner
AG03200051
MI
Other
Enumeration date
04/05/2020
Last updated
10/25/2021
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