1295031359 NPI number — MONICA M. ROSAS LADC-MH

Table of content: MRS. JUSTINA MAME ADADEWA ANKRAH LPCA (NPI 1063059731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295031359 NPI number — MONICA M. ROSAS LADC-MH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSAS
Provider First Name:
MONICA
Provider Middle Name:
M.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LADC-MH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HINKLEY
Provider Other First Name:
MONICA
Provider Other Middle Name:
M.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LADC-MH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1295031359
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
420 SW 10TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73109-5610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-236-0701
Provider Business Mailing Address Fax Number:
405-236-0737

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SSMH - ST. ANTHONY'S HOSPITAL
Provider Second Line Business Practice Location Address:
2825 PARKLAWN DRIVE
Provider Business Practice Location Address City Name:
MIDWEST CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-610-4411
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/07/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 1406 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: 1406 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)