Provider Demographics
NPI:1588631873
Name:MONAHAN, WILLIAM JAMES (FNP)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JAMES
Last Name:MONAHAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 RIDGEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3812
Mailing Address - Country:US
Mailing Address - Phone:610-356-5988
Mailing Address - Fax:
Practice Address - Street 1:113 RIDGEFIELD RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3812
Practice Address - Country:US
Practice Address - Phone:610-356-5988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-05
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017755363LF0000X
PARN502050L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse