Individual
PAMELA S MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
12101 CAROL LN, FREDERICKSBURG, VA 22407-6101
(540) 368-7835
(540) 368-7802
Mailing address
PO BOX 1460, FREDERICKSBURG, VA 22402-1460
(540) 786-2100
(540) 786-6673
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024100683
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02375
MEDICARE GROUP
VA
Enumeration date
10/26/2005
Last updated
10/29/2007
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