Individual
DEIDRA MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
200 DARUMA PKWY, MORAINE, OH 45439-7909
(937) 963-5512
(937) 496-5274
Mailing address
6692 SHULL RD, DAYTON, OH 45424-1223
(937) 516-8662
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.303072
OH
Other
Enumeration date
07/14/2020
Last updated
07/14/2020
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