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Individual

CONNIE SUE MCCULLICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 251-6100
(608) 260-2951
Mailing address
700 S PARK ST, MADISON, WI 53715-1830
(608) 251-6100
(608) 260-2951

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3628
WI
364SA2200X
Adult Health Clinical Nurse Specialist
3628
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1013358787
WI
Enumeration date
07/10/2013
Last updated
09/14/2021
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