Provider Demographics
NPI:1588346415
Name:WEST, MONIQUE (RN, BSN)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:
Other - Last Name:WEST-FIELDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:609 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-8376
Mailing Address - Country:US
Mailing Address - Phone:816-756-8567
Mailing Address - Fax:
Practice Address - Street 1:609 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:RAYMORE
Practice Address - State:MO
Practice Address - Zip Code:64083-8376
Practice Address - Country:US
Practice Address - Phone:816-756-8567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009029170163WG0000X, 163WI0500X, 163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy