Provider Demographics
NPI:1457006553
Name:MCGEE, MONICA RENEE (RN, CCM)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:RENEE
Last Name:MCGEE
Suffix:
Gender:F
Credentials:RN, CCM
Other - Prefix:MS
Other - First Name:MONICA
Other - Middle Name:RENEE
Other - Last Name:PROVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CCM
Mailing Address - Street 1:3458 N D ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-2418
Mailing Address - Country:US
Mailing Address - Phone:909-693-0859
Mailing Address - Fax:
Practice Address - Street 1:3458 N D ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-2418
Practice Address - Country:US
Practice Address - Phone:909-693-0859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA850188163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management