Provider Demographics
NPI:1972037786
Name:BATTLE, MONIQUE (FNP)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:BATTLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 SECOND AVE
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-2510
Mailing Address - Country:US
Mailing Address - Phone:518-921-4032
Mailing Address - Fax:
Practice Address - Street 1:189 SECOND AVE
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-2510
Practice Address - Country:US
Practice Address - Phone:518-921-4032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-90258163W00000X
NY712855163W00000X
NY347056363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse