Individual
CHASTITY MCCULLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1240 N BUTTERFIELD RD, BOLIVAR, MO 65613-3016
(417) 326-6021
(417) 326-6347
Mailing address
1240 N BUTTERFIELD RD, BOLIVAR, MO 65613-3016
(417) 326-6021
(417) 326-6347
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
431775217
MO
363LP2300X
Primary Care Nurse Practitioner
431775217
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477838571
—
MO
Enumeration date
10/20/2011
Last updated
03/06/2019
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