Provider Demographics
NPI:1033933296
Name:SIRMANS, MONA LISA
Entity type:Individual
Prefix:MS
First Name:MONA
Middle Name:LISA
Last Name:SIRMANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 PINE NEEDLE RD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:GA
Mailing Address - Zip Code:31647-3352
Mailing Address - Country:US
Mailing Address - Phone:229-585-2442
Mailing Address - Fax:
Practice Address - Street 1:95 PINE NEEDLE RD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:GA
Practice Address - Zip Code:31647-3352
Practice Address - Country:US
Practice Address - Phone:229-585-2442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN122196163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse