Individual
MRS. SUSAN JEAN MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
601 N 30TH ST, OMAHA, NE 68131-2137
(402) 280-4497
Mailing address
5015 WEBSTER ST, OMAHA, NE 68132-2209
(402) 553-5261
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
110499
NE
Other
Enumeration date
10/31/2006
Last updated
07/08/2007
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