Individual
MS. PATRICIA A MACCULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
119 BELMONT STREET, SPINCE CENTER, WORCESTER, MA 01605
(508) 334-1886
(508) 334-9769
Mailing address
119 BELMONT ST, WORCESTER, MA 01605-2903
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
241024
MA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN241024
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110074517A
—
MA
Enumeration date
09/19/2006
Last updated
10/11/2022
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