MISS JESSICA NICOLE MCCULLOUGH APRN FNP PMHNP NPI 1275730376

NPI Information

NPI: 1275730376
Provider Name: MISS JESSICA NICOLE MCCULLOUGH, APRN, FNP, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
14100 CEDAR RD STE 390-2
CLEVELAND, OH
ZIP 44121
Phone: (216) 905-0099
Get Directions

MISS Jessica Nicole Mccullough, APRN, FNP, PMHNP is a psychiatric/mental health nurse practitioner in Cleveland, OH. MISS Jessica Nicole Mccullough, APRN, FNP, PMHNP NPI is 1275730376. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

14100 CEDAR RD STE 390-2
CLEVELAND, OH
ZIP 44121-212
Phone: (216) 905-0099

The NPI 1275730376 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/2/2007 and was last updated on 3/2/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		312983	OHIO	No
2	363LF0000X	Nurse Practitioner	Family	14506	OHIO	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	14506	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0085765	MEDICAID	OHIO
2	2573433	OTHER	OHIO	PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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