Provider Demographics
NPI:1518190784
Name:VANZANDT, MONICA B
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:B
Last Name:VANZANDT
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 1:31 SYDNEY CT
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-4755
Mailing Address - Country:US
Mailing Address - Phone:888-877-9110
Mailing Address - Fax:985-809-1292
Practice Address - Street 1:13405 SEYMOUR MEYERS BLVD
Practice Address - Street 2:SUITE 15
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-6896
Practice Address - Country:US
Practice Address - Phone:888-877-9110
Practice Address - Fax:985-809-1292
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies