Provider Demographics
NPI:1710110804
Name:MUKHERJEE, MONICA (RN, BSN)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:
Last Name:MUKHERJEE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3876 DEER KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4140
Mailing Address - Country:US
Mailing Address - Phone:614-474-9994
Mailing Address - Fax:
Practice Address - Street 1:3876 DEER KNOLL DR
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-4140
Practice Address - Country:US
Practice Address - Phone:614-474-9994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH283869163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse