Monique Cordova

Key facts

NPI

1619359593

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

R40347 (ND)

Practice address

1200 Collins Ave
Mandan, ND 58554-2066

Phone

(701) 663-5373

NPI assigned

Jun 26, 2015

Sex

Female

Sole proprietor

No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dakota Home Care, Inc. Nursing Care Agency · Bismarck, ND · NPI 1780959809
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 26, 2015.

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1619359593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 COLLINS AVE",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585542066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 COLLINS AVE",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585542066",
            "telephone_number": "701-663-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "MONIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R40347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandan, ND

• Rhonda Cloud
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• Amber Cook
• Kelsey Copenhaver
• Dana Leann Cordova-Jacobson
• Beth Ellen Cose
• Paige Cossette
• Bethany Cox
• Jamie Laree Crane, M.P.T.
• Courtney Crisler

All providers in Mandan, ND · Registered Nurse in North Dakota