Provider Demographics
NPI:1457848798
Name:MONSON, ANNE VICTORIA (CPM)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:VICTORIA
Last Name:MONSON
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 KING LEAR DR
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-4541
Mailing Address - Country:US
Mailing Address - Phone:304-724-8328
Mailing Address - Fax:
Practice Address - Street 1:147 KING LEAR DR
Practice Address - Street 2:
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-4541
Practice Address - Country:US
Practice Address - Phone:301-302-4313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-20
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0129-000160176B00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
No374J00000XNursing Service Related ProvidersDoula