Provider Demographics
NPI:1093356792
Name:MONNIG, KATHLEEN ELISE
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ELISE
Last Name:MONNIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 ZEHRING RD
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45325-9237
Mailing Address - Country:US
Mailing Address - Phone:937-673-3452
Mailing Address - Fax:
Practice Address - Street 1:2130 ZEHRING RD
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45325-9237
Practice Address - Country:US
Practice Address - Phone:937-673-3452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer