Provider Demographics
NPI:1619577335
Name:MONASMITH, MONICA RASHELL
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:RASHELL
Last Name:MONASMITH
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 1:1800 MORMON MILL RD STE A6
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-4176
Mailing Address - Country:US
Mailing Address - Phone:512-234-4050
Mailing Address - Fax:
Practice Address - Street 1:1800 MORMON MILL RD STE A6
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-4176
Practice Address - Country:US
Practice Address - Phone:512-234-4050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX018627374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018627OtherHCCSA LICENSE