Provider Demographics
NPI:1417788001
Name:MONBOE, AMINTA (CRNP-ACUTE CARE)
Entity type:Individual
Prefix:
First Name:AMINTA
Middle Name:
Last Name:MONBOE
Suffix:
Gender:F
Credentials:CRNP-ACUTE CARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 HIDDEN STREAM CT
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21158-9491
Mailing Address - Country:US
Mailing Address - Phone:443-853-0969
Mailing Address - Fax:
Practice Address - Street 1:700 HIDDEN STREAM CT
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21158-9491
Practice Address - Country:US
Practice Address - Phone:443-853-0969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR232064363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care