Provider Demographics
NPI:1518074327
Name:MONROE, JANICE K (FNP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:K
Last Name:MONROE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 SW HWY 97
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MADRAS
Mailing Address - State:OR
Mailing Address - Zip Code:97741
Mailing Address - Country:US
Mailing Address - Phone:541-454-2888
Mailing Address - Fax:541-454-2988
Practice Address - Street 1:910 SW HWY 97
Practice Address - Street 2:SUITE 101
Practice Address - City:MADRAS
Practice Address - State:OR
Practice Address - Zip Code:97741
Practice Address - Country:US
Practice Address - Phone:541-475-7800
Practice Address - Fax:541-475-6600
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR087003014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily