Individual
TANA MCCOULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, FNP-C
Contact information
Practice address
2402 ATHERHOLT RD, LYNCHBURG, VA 24501
(434) 455-3275
Mailing address
3905 WOODBRIDGE CT, CHESTER, VA 23831-4755
(804) 839-1401
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024174936
VA
367A00000X
Advanced Practice Midwife
Primary
0024174936
VA
Other
Enumeration date
07/21/2016
Last updated
02/15/2019
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