Provider Demographics
NPI:1265691679
Name:MONROE, MONTRICIA LEWIS (NP-C)
Entity type:Individual
Prefix:
First Name:MONTRICIA
Middle Name:LEWIS
Last Name:MONROE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WESTWOOD PL STE 300
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7554
Mailing Address - Country:US
Mailing Address - Phone:866-686-2504
Mailing Address - Fax:
Practice Address - Street 1:3803 N ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2593
Practice Address - Country:US
Practice Address - Phone:866-686-2504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5003972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCCIGNA HEATHCAREOtherCIGNA HEATHCARE
NCS C MEDICAIDOtherSOUTH CAROLINA MEDICAID
NCAETNAOtherAETNA
NCUNITED HEATHCAREOtherUNITED HEATHCARE
NCBCBSNCOtherBLUE CROSS BLUE SHIELD
NCMEDICAIDMedicaid
NCBCBSNCOtherBLUE CROSS BLUE SHIELD