Individual
MS. MONICA HERMINE MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
3525 E LOUISE DR STE 250, MERIDIAN, ID 83642-6303
(208) 381-7312
Mailing address
3405 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4399
(267) 426-5421
(215) 590-6804
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
TP004475D
PA
Other
Enumeration date
05/22/2008
Last updated
01/06/2020
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