Provider Demographics
NPI:1912655234
Name:MONROE, JOAN WILLIAMSON (FNP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:WILLIAMSON
Last Name:MONROE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:REBEKAH
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 936857
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-6857
Mailing Address - Country:US
Mailing Address - Phone:910-662-7720
Mailing Address - Fax:910-815-0840
Practice Address - Street 1:2221 S 17TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7542
Practice Address - Country:US
Practice Address - Phone:910-662-7720
Practice Address - Fax:910-777-5961
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMONR-OJRKB363LF0000X
NC5016963363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily