Provider Demographics
NPI:1477378453
Name:STAS, MONICA (BSN, RN, CA-SANE)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:STAS
Suffix:
Gender:F
Credentials:BSN, RN, CA-SANE
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:DRIGGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:118 CHRISSA DR
Mailing Address - Street 2:
Mailing Address - City:POTTSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75076-7061
Mailing Address - Country:US
Mailing Address - Phone:405-639-9441
Mailing Address - Fax:
Practice Address - Street 1:1716 BRIARCREST DR STE 200
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2764
Practice Address - Country:US
Practice Address - Phone:979-436-0221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX970420163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse