Provider Demographics
NPI:1093593162
Name:SAN JUAN, MONICA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:SAN JUAN
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 1:8800 NAIRN CT # NA
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-9407
Mailing Address - Country:US
Mailing Address - Phone:614-973-3551
Mailing Address - Fax:
Practice Address - Street 1:8800 NAIRN CT # NA
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-9407
Practice Address - Country:US
Practice Address - Phone:614-973-3551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker