Healthcare Provider Details
I. General information
NPI: 1285004879
Provider Name (Legal Business Name): MONIKA MCDONALD CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/25/2015
Last Update Date: 10/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
440 E MARSHALL ST SUITE 201
WEST CHESTER PA
19380-5414
US
IV. Provider business mailing address
440 E MARSHALL ST SUITE 201
WEST CHESTER PA
19380-5414
US
V. Phone/Fax
- Phone: 610-738-2500
- Fax: 610-738-2540
- Phone: 610-738-2500
- Fax: 610-738-2540
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | SP015177 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: