Provider Demographics
NPI:1316184831
Name:KEULEN-NOLET, MONIQUE Y (FNP RN MSN)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:Y
Last Name:KEULEN-NOLET
Suffix:
Gender:F
Credentials:FNP RN MSN
Other - Prefix:MRS
Other - First Name:MONIQUE
Other - Middle Name:Y
Other - Last Name:LOPEZ-NOLET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:44 EL CIELO AZUL CIR
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:NM
Mailing Address - Zip Code:87015-7916
Mailing Address - Country:US
Mailing Address - Phone:505-281-8493
Mailing Address - Fax:
Practice Address - Street 1:12127B NORTH HIGHWAY 14
Practice Address - Street 2:SUITE #5
Practice Address - City:CEDAR CREST
Practice Address - State:NM
Practice Address - Zip Code:87008
Practice Address - Country:US
Practice Address - Phone:505-281-2460
Practice Address - Fax:505-281-2463
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2010-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR 34614363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily