Provider Demographics
NPI:1760816672
Name:THOMPSON, MONICA CHARISSE (STNA)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:CHARISSE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8218 KINGSMERE CT.
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231
Mailing Address - Country:US
Mailing Address - Phone:513-931-5448
Mailing Address - Fax:
Practice Address - Street 1:8218 KINGSMERE CT
Practice Address - Street 2:8218 KINGSMERE COURT
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-6006
Practice Address - Country:US
Practice Address - Phone:513-931-5448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH375333730196376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide