Individual
CHRISTAL ANN MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
526 OLD LIVERPOOL RD, LIVERPOOL, NY 13088-6238
(315) 453-3911
(315) 453-0197
Mailing address
79 GLENRIDGE RD, GLENVILLE, NY 12302-4523
(518) 952-8408
(518) 952-8287
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
718284
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420800
—
NY
Enumeration date
08/24/2016
Last updated
12/22/2016
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