Provider Demographics
NPI:1780820761
Name:NYLUND-ALM, MONIQUE C (ANP-BC)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:C
Last Name:NYLUND-ALM
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 PENNSYLVANIA AVENUE, NW
Mailing Address - Street 2:SUITE 4 -417
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037
Mailing Address - Country:US
Mailing Address - Phone:202-741-2323
Mailing Address - Fax:202-741-2324
Practice Address - Street 1:2150 PENNSYLVANIA AVE NW
Practice Address - Street 2:SUITE 4-417
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-3201
Practice Address - Country:US
Practice Address - Phone:202-741-2323
Practice Address - Fax:202-741-2324
Is Sole Proprietor?:No
Enumeration Date:2008-12-23
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY476573-1163W00000X
VA0001199511163W00000X
NYF303367363LA2200X
VA0024166937363LA2200X
DCRN1015543363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ13483Medicare UPIN