Provider Demographics
NPI:1740955517
Name:VELDHUIZEN, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:VELDHUIZEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8442 W MARIPOSA GRANDE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-1285
Mailing Address - Country:US
Mailing Address - Phone:623-349-3763
Mailing Address - Fax:
Practice Address - Street 1:8442 W MARIPOSA GRANDE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-1285
Practice Address - Country:US
Practice Address - Phone:623-349-3763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program