Provider Demographics
NPI:1013192020
Name:MCCULLION, JEANINE (CRNA)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:
Last Name:MCCULLION
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNITED ANESTHESIA SERVICE PC
Mailing Address - Street 2:610 W. GERMANTOWN AVENUE-SUITE 150
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462
Mailing Address - Country:US
Mailing Address - Phone:610-525-4966
Mailing Address - Fax:610-525-0874
Practice Address - Street 1:ROTHMAN ORTHOPAEDIC SPECIALTY HOSPITAL
Practice Address - Street 2:3300 TILLMAN DRIVE
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020
Practice Address - Country:US
Practice Address - Phone:215-244-7400
Practice Address - Fax:215-940-9456
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN330883L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered