Basic Information
Provider Information
NPI: 1083813729
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MONSON
FirstName: TERESA
MiddleName: K
NamePrefix: MISS
NameSuffix:  
Credential: AOS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2033 E 102ND CIR
Address2:  
City: THORNTON
State: CO
PostalCode: 802292331
CountryCode: US
TelephoneNumber: 3034333944
FaxNumber:  
Practice Location
Address1: 2033 E 102ND CIR
Address2:  
City: THORNTON
State: CO
PostalCode: 802292331
CountryCode: US
TelephoneNumber: 3034333944
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/13/2007
LastUpdateDate: 07/13/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
376K00000XCNA 702445COY Nursing Service Related ProvidersNurse's Aide 

No ID Information.


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