Provider Demographics
NPI:1851797294
Name:MONCION, ANNETTE (NP)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:MONCION
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 MIDLAND LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-4152
Mailing Address - Country:US
Mailing Address - Phone:678-403-1224
Mailing Address - Fax:
Practice Address - Street 1:32 MIDLAND LANE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157
Practice Address - Country:US
Practice Address - Phone:678-403-1224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-12
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN183586363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care