Provider Demographics
NPI:1588312060
Name:LABAUVE, MONIQUE ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:ELIZABETH
Last Name:LABAUVE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 SAXONY RD STE 207
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-6777
Mailing Address - Country:US
Mailing Address - Phone:760-942-2991
Mailing Address - Fax:
Practice Address - Street 1:171 SAXONY RD STE 207
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-6777
Practice Address - Country:US
Practice Address - Phone:760-942-2991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF0900142363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner