Individual
JASMINE JERNEISE MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
41800 W 11 MILE RD STE 109, NOVI, MI 48375-1818
(248) 660-1220
Mailing address
41800 W 11 MILE RD STE 109, NOVI, MI 48375-1818
(248) 660-1220
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
29963
SC
363LF0000X
Family Nurse Practitioner
Primary
5021831
NC
363LP2300X
Primary Care Nurse Practitioner
29963
SC
363LP2300X
Primary Care Nurse Practitioner
5021831
NC
Other
Enumeration date
02/11/2025
Last updated
07/11/2025
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