Provider Demographics
NPI:1154331122
Name:MONROE, CAROL J (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:J
Last Name:MONROE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6075 RAND BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-5126
Mailing Address - Country:US
Mailing Address - Phone:941-921-2792
Mailing Address - Fax:941-925-2438
Practice Address - Street 1:6075 RAND BLVD STE 1
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5126
Practice Address - Country:US
Practice Address - Phone:941-921-2792
Practice Address - Fax:941-925-2438
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002622363LP0808X
FLAPRN11014213363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004227105Medicaid