Provider Demographics
NPI:1770788416
Name:MENTZER, MONICA JOAN
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:JOAN
Last Name:MENTZER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MONICA
Other - Middle Name:JOAN
Other - Last Name:SWEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1329 FARLEY CT SOUTH
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012
Mailing Address - Country:US
Mailing Address - Phone:410-222-7256
Mailing Address - Fax:410-222-7490
Practice Address - Street 1:1 HARRY S TRUMAN PKWY
Practice Address - Street 2:ANNE ARUNDEL COUNTY DEPT OF HEALTH SUITE 231
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401
Practice Address - Country:US
Practice Address - Phone:410-222-7256
Practice Address - Fax:410-222-7490
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR114269163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse