Individual
LISA RAE MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1400 E BOULDER ST, COLORADO SPRINGS, CO 80909-5533
(719) 447-8812
(719) 447-8987
Mailing address
4722 N 24TH ST, STE 150, PHOENIX, AZ 85016-4800
(877) 737-4546
(602) 957-9438
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
5336
CO
Other
Enumeration date
07/24/2008
Last updated
07/24/2008
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