Provider Demographics
NPI:1821986084
Name:JOHNSON, MONIQUE N (RN)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:N
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11413 MALAGA SKY PL
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-1937
Mailing Address - Country:US
Mailing Address - Phone:561-309-1217
Mailing Address - Fax:
Practice Address - Street 1:11413 MALAGA SKY PL
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637-1937
Practice Address - Country:US
Practice Address - Phone:561-309-1217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9619283163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse