Provider Demographics
NPI:1003062498
Name:FELIX, MONNICA DIANNE
Entity Type:Individual
Prefix:MS
First Name:MONNICA
Middle Name:DIANNE
Last Name:FELIX
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MONICA
Other - Middle Name:DIANE
Other - Last Name:FELIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1930 CHARLES PL
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-4232
Mailing Address - Country:US
Mailing Address - Phone:254-338-9594
Mailing Address - Fax:
Practice Address - Street 1:1930 CHARLES PL
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-4232
Practice Address - Country:US
Practice Address - Phone:254-338-9594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX655029364SC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine