Individual
CARA JEAN MCCULLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, FNP-BC
Contact information
Practice address
2702 JACKSBORO PIKE, JACKSBORO, TN 37757-4850
(423) 201-9937
Mailing address
270 SHARP CREEK RD, LA FOLLETTE, TN 37766-6112
(865) 617-1045
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19236
TN
363LF0000X
Family Nurse Practitioner
3009180
KY
Other
Enumeration date
01/21/2015
Last updated
01/21/2015
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