Provider Demographics
NPI:1528290087
Name:MASON, MONICA LEAH (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:LEAH
Last Name:MASON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MISS
Other - First Name:MONICA
Other - Middle Name:LEAH
Other - Last Name:MCCALLISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 BROOKS ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1319
Mailing Address - Country:US
Mailing Address - Phone:304-346-8877
Mailing Address - Fax:304-414-5218
Practice Address - Street 1:601 BROOKS ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1319
Practice Address - Country:US
Practice Address - Phone:304-346-8877
Practice Address - Fax:304-414-5218
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN60712-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily