Provider Demographics
NPI:1760098222
Name:SIZEMORE, MONICA SHEA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:SHEA
Last Name:SIZEMORE
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 1:208 TRACE ST APT 23
Mailing Address - Street 2:
Mailing Address - City:MULLENS
Mailing Address - State:WV
Mailing Address - Zip Code:25882-1652
Mailing Address - Country:US
Mailing Address - Phone:681-220-4821
Mailing Address - Fax:
Practice Address - Street 1:208 TRACE ST APT 23
Practice Address - Street 2:
Practice Address - City:MULLENS
Practice Address - State:WV
Practice Address - Zip Code:25882-1652
Practice Address - Country:US
Practice Address - Phone:681-220-4821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant