Provider Demographics
NPI:1962244384
Name:MICHAUD, MONIQUE EMMA (RN)
Entity type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:EMMA
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:MONIQUE
Other - Middle Name:MICHAUD
Other - Last Name:BOIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:84 PLEASANT ST.
Mailing Address - Street 2:
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743
Mailing Address - Country:US
Mailing Address - Phone:207-834-5540
Mailing Address - Fax:207-945-1720
Practice Address - Street 1:84 PLEASANT ST.
Practice Address - Street 2:
Practice Address - City:FORT KENT
Practice Address - State:ME
Practice Address - Zip Code:04743
Practice Address - Country:US
Practice Address - Phone:207-834-5540
Practice Address - Fax:207-945-1720
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME121200.228738163WS0200X
ME786930364SS0200X
MERN41312163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No364SS0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistSchool