Provider Demographics
NPI:1093301277
Name:DEAN, MONICA CHRISTINE (INDEPENDENT PROVIDER)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:CHRISTINE
Last Name:DEAN
Suffix:
Gender:F
Credentials:INDEPENDENT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-2138
Mailing Address - Country:US
Mailing Address - Phone:216-290-9019
Mailing Address - Fax:
Practice Address - Street 1:2511 E 34TH ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-2138
Practice Address - Country:US
Practice Address - Phone:216-290-9019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide