Provider Demographics
NPI:1215200613
Name:MONAHAN, DEBORAH ELIZABETH (NP-C)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ELIZABETH
Last Name:MONAHAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:MONAHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-C
Mailing Address - Street 1:305 RIVER DR
Mailing Address - Street 2:
Mailing Address - City:LOLO
Mailing Address - State:MT
Mailing Address - Zip Code:59847-8732
Mailing Address - Country:US
Mailing Address - Phone:406-370-9376
Mailing Address - Fax:
Practice Address - Street 1:605 E HOLLAND AVE STE 100
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1246
Practice Address - Country:US
Practice Address - Phone:509-228-1000
Practice Address - Fax:509-252-9300
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-24252363LF0000X
WAAP61129129363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily