Provider Demographics
NPI:1205010139
Name:REESE, MONIQUE C (MSN, ARNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:C
Last Name:REESE
Suffix:
Gender:F
Credentials:MSN, ARNP, FNP-C
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:C
Other - Last Name:FENTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:11333 AURORA AVE
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-7908
Mailing Address - Country:US
Mailing Address - Phone:515-557-3100
Mailing Address - Fax:515-557-3226
Practice Address - Street 1:11333 AURORA AVE
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-7908
Practice Address - Country:US
Practice Address - Phone:515-557-3100
Practice Address - Fax:515-557-3226
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA109270363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily