Healthcare Provider Details

I. General information

NPI: 1730407750
Provider Name (Legal Business Name): MONICA MUSSER GIANOPULOS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 05/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34TH ST AND CIVIC CENTER BLVD
PHILADELPHIA PA
19104
US

IV. Provider business mailing address

34 RABBIT RUN
ROSE VALLEY PA
19086
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-1000
  • Fax:
Mailing address:
  • Phone: 610-566-0432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN297181L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberVP006685D
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: