Provider Demographics
NPI:1073197471
Name:MONROE, ANDREW (ARNP)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:MONROE
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1590 353RD AVE
Mailing Address - Street 2:
Mailing Address - City:WEVER
Mailing Address - State:IA
Mailing Address - Zip Code:52658-9502
Mailing Address - Country:US
Mailing Address - Phone:319-850-8821
Mailing Address - Fax:
Practice Address - Street 1:1223 S GEAR AVE STE 303
Practice Address - Street 2:
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1670
Practice Address - Country:US
Practice Address - Phone:319-768-3925
Practice Address - Fax:319-768-3937
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00000000363L00000X
390200000X
IAA163541363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program