Provider Demographics
NPI:1851598551
Name:PIS, MONIKA BEATA (PHD, CPNP)
Entity Type:Individual
Prefix:DR
First Name:MONIKA
Middle Name:BEATA
Last Name:PIS
Suffix:
Gender:F
Credentials:PHD, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1025 MILITARY TRAIL
Mailing Address - Street 2:SUITE # 109
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:561-741-0000
Mailing Address - Fax:561-745-4212
Practice Address - Street 1:1025 MILITARY TRAIL
Practice Address - Street 2:SUITE #109
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-741-0000
Practice Address - Fax:561-741-0002
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704226882363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner