Provider Demographics
NPI:1376979179
Name:STEELE, MONIQUE DASHAY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:DASHAY
Last Name:STEELE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:MONIQUE
Other - Middle Name:DASHAY
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:33400 VINE ST
Mailing Address - Street 2:102D
Mailing Address - City:WILLOWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44095-3471
Mailing Address - Country:US
Mailing Address - Phone:216-316-8381
Mailing Address - Fax:
Practice Address - Street 1:33400 VINE ST
Practice Address - Street 2:102D
Practice Address - City:WILLOWICK
Practice Address - State:OH
Practice Address - Zip Code:44095-3471
Practice Address - Country:US
Practice Address - Phone:216-316-8381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.144739-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse