Provider Demographics
NPI:1316289903
Name:MONROE, JO ANNA LEA (CRNP)
Entity type:Individual
Prefix:
First Name:JO ANNA
Middle Name:LEA
Last Name:MONROE
Suffix:
Gender:F
Credentials:CRNP
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 626
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35653-0626
Mailing Address - Country:US
Mailing Address - Phone:256-332-6208
Mailing Address - Fax:256-332-6213
Practice Address - Street 1:101 JAMES HOVATER RD
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AL
Practice Address - Zip Code:35653-8004
Practice Address - Country:US
Practice Address - Phone:256-332-6208
Practice Address - Fax:256-332-6213
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-090589363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALNPIOther1316289903
AL1326373861OtherGROUP NPI