Provider Demographics
NPI:1003148735
Name:MONAGHAN, MARY REBECCA (APN)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:REBECCA
Last Name:MONAGHAN
Suffix:
Gender:F
Credentials:APN
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Other - First Name:
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Mailing Address - Street 1:25440 INTERSTATE 45 N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1343
Mailing Address - Country:US
Mailing Address - Phone:281-419-1599
Mailing Address - Fax:281-419-5885
Practice Address - Street 1:25440 INTERSTATE 45 N
Practice Address - Street 2:SUITE 300
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77386-1343
Practice Address - Country:US
Practice Address - Phone:281-419-1599
Practice Address - Fax:281-419-5885
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX596032163WG0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice