Individual
TARA LYNN MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2004 FORD PKWY, SAINT PAUL, MN 55116-1931
(612) 256-8225
(612) 457-0216
Mailing address
2004 FORD PKWY, SAINT PAUL, MN 55116-1931
(612) 256-8225
(612) 457-0216
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5944
MN
Other
Enumeration date
08/08/2018
Last updated
10/30/2024
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