Individual
DR. NICHOLAS MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP-NA, CRNA
Contact information
Practice address
4600 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508-6902
(337) 521-9100
Mailing address
204 MILTON ESTATES LN, YOUNGSVILLE, LA 70592-6089
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
210732
LA
Other
Enumeration date
01/02/2020
Last updated
01/02/2020
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