Individual
DIANE RENEE MCCULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
7925 YOUREE DR, SUITE 280A, SHREVEPORT, LA 71105-5538
(318) 798-6833
(318) 798-6835
Mailing address
7925 YOUREE DR, SUITE 280A, SHREVEPORT, LA 71105-5538
(318) 798-6833
(318) 798-6835
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN051830
LA
363L00000X
Nurse Practitioner
Primary
APL-APO 1867
LA
Other
Enumeration date
04/20/2007
Last updated
09/11/2025
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