Provider Demographics
NPI:1053381392
Name:MONNETT, MARCIA DENISE (MS APRN CSP)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:DENISE
Last Name:MONNETT
Suffix:
Gender:F
Credentials:MS APRN CSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 980
Mailing Address - Street 2:975 N SOLOMONS ISLAND RD
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678
Mailing Address - Country:US
Mailing Address - Phone:410-535-5400
Mailing Address - Fax:410-414-9413
Practice Address - Street 1:975 N SOLOMONS ISLAND RD
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678
Practice Address - Country:US
Practice Address - Phone:410-535-5400
Practice Address - Fax:410-414-9413
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR055596163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health