Provider Demographics
NPI:1801839824
Name:ENGEL, MONIQUE DEE (MS, RD, LMNT)
Entity Type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:DEE
Last Name:ENGEL
Suffix:
Gender:F
Credentials:MS, RD, LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8830 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-1455
Mailing Address - Country:US
Mailing Address - Phone:402-770-1941
Mailing Address - Fax:
Practice Address - Street 1:3763 39TH AVE STE 400
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-4530
Practice Address - Country:US
Practice Address - Phone:402-563-0312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE739133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47079687563Medicaid
942816OtherCDR
NE47079687563Medicaid