Individual
LEIA JUNE MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PMHNP
Contact information
Practice address
44 BONNIE LN, SYLVA, NC 28779-8511
(828) 631-3973
(828) 631-9280
Mailing address
PO BOX 2187, SYLVA, NC 28779-2187
(828) 631-3973
(828) 631-9280
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
219356
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5011033
NC
Other
Enumeration date
02/09/2010
Last updated
10/07/2019
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