Provider Demographics
NPI:1265645709
Name:SPRAGUE, MONICA ROSE (RN-CS, MSN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:ROSE
Last Name:SPRAGUE
Suffix:
Gender:F
Credentials:RN-CS, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 VALLECITOS DE ORO STE A
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-1423
Mailing Address - Country:US
Mailing Address - Phone:760-235-8784
Mailing Address - Fax:
Practice Address - Street 1:125 VALLECITOS DE ORO STE A
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-1423
Practice Address - Country:US
Practice Address - Phone:760-235-8784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA437881363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily