Provider Demographics
NPI:1821142209
Name:DELABARRE, MONICA JOAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:JOAN
Last Name:DELABARRE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:COUSIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2311 E WEST HART RD
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-1811
Mailing Address - Country:US
Mailing Address - Phone:608-362-2270
Mailing Address - Fax:
Practice Address - Street 1:930 N WASHINGTON ST
Practice Address - Street 2:APT 130
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-2876
Practice Address - Country:US
Practice Address - Phone:608-756-5111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35009200Medicaid