Provider Demographics
NPI:1295570505
Name:MONROE, ANNA ROSE MELISIE (ARNP)
Entity type:Individual
Prefix:DR
First Name:ANNA ROSE
Middle Name:MELISIE
Last Name:MONROE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 POTTERY AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-2593
Mailing Address - Country:US
Mailing Address - Phone:360-876-5440
Mailing Address - Fax:360-876-0718
Practice Address - Street 1:1950 POTTERY AVE STE 140
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-2593
Practice Address - Country:US
Practice Address - Phone:360-876-5440
Practice Address - Fax:360-876-0718
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61574739207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine