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NPI Code Detail

MEDICARE: MONIQUE NEAULT CRNP

MEDICARE: MONIQUE NEAULT CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse PractitionerSP009884PA
2363LA2200XAdult Health Nurse PractitionerSP009659PA

General Provider Information

NPI Number : 1376791541
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONIQUE NEAULT CRNP
Provider Business Mailing Address
First Line : 3900 WOODLAND AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4551
Country : US
Telephone Number : 267-253-5286
Fax Number :
Provider Business Practice Location Address
First Line : 3900 WOODLAND AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4551
Country : US
Telephone Number : 215-253-5286
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2008
Last Update Date : 03/07/2026

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