Provider Demographics
NPI:1790499820
Name:CHECA, MONIKA ANGELA
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:ANGELA
Last Name:CHECA
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 1:130 MCGHEE RD STE 130
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-8409
Mailing Address - Country:US
Mailing Address - Phone:208-263-0450
Mailing Address - Fax:
Practice Address - Street 1:130 MCGHEE RD STE 130
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-8409
Practice Address - Country:US
Practice Address - Phone:208-263-0450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID74424363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily