Individual
COLLETTE SMITH MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
800 5TH ST, SIOUX CITY, IA 51101-1317
(712) 202-0777
Mailing address
800 5TH ST, SIOUX CITY, IA 51101-1317
(712) 202-0777
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
053998
IA
363L00000X
Nurse Practitioner
Z-053998
IA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Z-053998
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053998
RN LICENSE
IA
01
—
Z-053998
ARNP-CNS LICENSES
IA
Enumeration date
07/20/2006
Last updated
09/11/2025
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