Provider Demographics
NPI:1952036402
Name:POESKE, MONICA JANE (MSN, CRNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:JANE
Last Name:POESKE
Suffix:
Gender:F
Credentials:MSN, CRNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 PARKSIDE AVE # 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-4751
Mailing Address - Country:US
Mailing Address - Phone:978-578-3651
Mailing Address - Fax:
Practice Address - Street 1:5050 PARKSIDE AVE # 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-4751
Practice Address - Country:US
Practice Address - Phone:215-383-0341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025410363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
15661808OtherCAQH