Provider Demographics
NPI:1992416085
Name:TEJEDA, MONICA (NP)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:TEJEDA
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 1:1189 WAIMANU ST APT 3307
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4184
Mailing Address - Country:US
Mailing Address - Phone:917-288-4733
Mailing Address - Fax:
Practice Address - Street 1:1189 WAIMANU ST APT 3307
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4184
Practice Address - Country:US
Practice Address - Phone:917-288-4733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF348309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily