Mccullough, Jessica Nicole

Mccullough, Jessica Nicole is an individual health care provider with primary practice located at 14100 Cedar Rd Ste 390-2 , Cleveland OH 44121-3212. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Mccullough, Jessica Nicole can be contacted via phone (216) 905-0099.

Contact Information

Primary practice address
14100 Cedar Rd Ste 390-2 Cleveland OH 44121-3212
Phone: (216) 905-0099
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 312983 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 14506 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 14506 Ohio

Profile Details

NPI number 1275730376
LBN Legal business name Mccullough, Jessica Nicole
Credentials APRN, FNP, PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2007
Last updated Mar 2nd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275730376 NPPES
Ohio MEDICAID 0085765
Ohio Other 2573433

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