Provider Demographics
NPI:1962210955
Name:MCCALL, MONAE ALISIA (RN)
Entity type:Individual
Prefix:MRS
First Name:MONAE
Middle Name:ALISIA
Last Name:MCCALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MONAE
Other - Middle Name:ALISIA
Other - Last Name:MCBRIDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7140 STAMFORD CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3539
Mailing Address - Country:US
Mailing Address - Phone:334-392-2805
Mailing Address - Fax:
Practice Address - Street 1:2105 E SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2409
Practice Address - Country:US
Practice Address - Phone:334-288-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-21
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-152563163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse