Individual
MRS. NICOLE ANI MUKALIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
925 CHESTNUT ST, SUITE 320A, PHILADELPHIA, PA 19107-4216
(215) 955-8874
(215) 955-2340
Mailing address
242 S 8TH ST, APARTMENT 4, PHILADELPHIA, PA 19107-5727
(516) 455-5237
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP014722
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103188469
—
PA
Enumeration date
04/08/2015
Last updated
11/01/2016
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