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Individual

MRS. LAUREL CARRIE MCCULLOH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 220-6360
(580) 220-6708
Mailing address
1515 6TH AVE SW, ARDMORE, OK 73401-3530
(580) 220-6360
(580) 220-6708

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0061952
OK

Other

Enumeration date
02/09/2007
Last updated
03/21/2013
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