Individual
ANDREW BLAKE MCCAULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
1507 W QUITMAN ST, IUKA, MS 38852-1133
(662) 423-1000
Mailing address
1507 W QUITMAN ST, IUKA, MS 38852
(662) 423-1000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904105
MS
Other
Enumeration date
08/27/2020
Last updated
08/27/2020
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