Provider Demographics
NPI:1346631793
Name:CONSUL, MONICA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:CONSUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4511 LAUREL ST
Mailing Address - Street 2:APT 24
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1147
Mailing Address - Country:US
Mailing Address - Phone:907-782-8033
Mailing Address - Fax:
Practice Address - Street 1:4511 LAUREL ST
Practice Address - Street 2:APT 24
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1147
Practice Address - Country:US
Practice Address - Phone:907-782-8033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK36863163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse