Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 71005907A | IN |
NPI | 1003291840 |
---|---|
Provider Name | Julie Mongeri-Mcpherson |
First Address | Muncie, IN 47303-3428 |
Second Address | Muncie, IN 47304-3988 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2015 |
Last Update Date | 12/02/2016 |