Individual
MRS. ANDREA MARIE MCCULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, AGACNP-BC
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(734) 740-6085
Mailing address
401 W HARGETT ST APT 728, RALEIGH, NC 27603-4082
(734) 740-6085
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ALLE-FVSF53
NC
363LA2100X
Acute Care Nurse Practitioner
Primary
5011544
NC
363LG0600X
Gerontology Nurse Practitioner
5011544
NC
Other
Enumeration date
03/04/2019
Last updated
08/07/2022
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