Individual
MS. MARY EVELYN MCCULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
4650 W SUNSET BLVD, MS #66, LOS ANGELES, CA 90027-6062
(323) 361-4148
Mailing address
4650 W SUNSET BLVD, MS #66, LOS ANGELES, CA 90027-6062
(323) 361-4148
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
448484
CA
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
448484
CA
Other
Enumeration date
08/06/2010
Last updated
08/06/2010
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