Provider Demographics
NPI:1497873855
Name:KALICH, MONNA P (RN, CRRN)
Entity Type:Individual
Prefix:MRS
First Name:MONNA
Middle Name:P
Last Name:KALICH
Suffix:
Gender:F
Credentials:RN, CRRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 518
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:OH
Mailing Address - Zip Code:44234-0518
Mailing Address - Country:US
Mailing Address - Phone:330-274-8046
Mailing Address - Fax:330-274-8056
Practice Address - Street 1:5555 GLENDON CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-3249
Practice Address - Country:US
Practice Address - Phone:330-274-8046
Practice Address - Fax:330-274-8056
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN198466163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse