Provider Demographics
NPI:1902027766
Name:MONROE, PENNY KAY (RN)
Entity Type:Individual
Prefix:
First Name:PENNY
Middle Name:KAY
Last Name:MONROE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 TAR HEEL DRIVE
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015
Mailing Address - Country:US
Mailing Address - Phone:740-990-9710
Mailing Address - Fax:
Practice Address - Street 1:332 TAR HEEL DRIVE
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015
Practice Address - Country:US
Practice Address - Phone:740-990-9710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3000895163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse