Monica Marie Wallace, RN
Individual provider Active NPI Registered Nurse · Cookstown, NJ
NPI 1245170604 · NPPES record last updated Mar 28, 2026
Key facts
- NPI
- 1245170604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 26NR11552100 (NJ)
- Practice address
- 3 Laburnum Close
Cookstown, NJ 08511-1203 - Phone
- (609) 217-4215
- NPI assigned
- Mar 28, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NR11552100 | NJ | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 26NR11552100 | NJ | Yes |
Addresses
Primary practice location
3 Laburnum Close
Cookstown, NJ 08511-1203
Mailing address
3 Laburnum Close
Cookstown, NJ 08511-1203
Phone (609) 217-4215
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.