MS. ANDREA N MCCULLOCH (NPI# 1104192772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104192772 |
| Entity Type | Individual |
| Full Name | MS. ANDREA N MCCULLOCH |
| Credential | PNP |
| Practice Address |
6526 Lansdowne Ave Saint Louis MO 63109-2654 |
| Practice Telephone | 3143538777 |
| Practice Fax Number | 3143538772 |
| Mailing Telephone | 3143538777 |
| Mailing Fax Number | 3143538772 |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2019-06-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
2012005442 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 420057535 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316405905 | Andrea Marie Mcculloch | Nurse Practitioner | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2019-03-04 |
| Street Address |
6526 LANSDOWNE AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63109-2654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982675641 | Jerome H O'neil Jr. | Pediatrics | 6526 Lansdowne Ave, Saint Louis, MO 63109-2654 | 2006-01-31 |
| 1972091825 | Wuca Southwest Pediatrics LLC | Clinic/Center | 6526 Lansdowne Ave, Saint Louis, MO 63109-2654 | 2018-04-26 |
| 1275927121 | Veronica Joan Wright | Nurse Practitioner | 6526 Lansdowne Ave, Saint Louis, MO 63109-2654 | 2015-03-27 |
| 1508112301 | Shilpa T. Menolascino | Pediatrics | 6526 Lansdowne Ave, Saint Louis, MO 63109-2654 | 2012-07-30 |
| 1336302660 | Sarah Elizabeth Aubuchon | Pediatrics | 6526 Lansdowne Ave, Saint Louis, MO 63109-2654 | 2008-07-07 |
| 1851437362 | Southwest Pediatrics, Inc. | Pediatrics | 6526 Lansdowne Ave, Saint Louis, MO 63109-2654 | 2007-01-30 |
| 1578534236 | Robert D Spewak | Pediatrics | 6526 Lansdowne Ave, Saint Louis, MO 63109-2654 | 2006-01-31 |
| 1417928078 | Karen L Whiteside | Pediatrics | 6526 Lansdowne Ave, Saint Louis, MO 63109-2654 | 2006-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013431907 | James Edward Trout | Community Health Worker | 3956 Wenzlick Ave, St Louis, MO 63109 | 2017-08-01 |
| 1750815023 | Andrea Hyde | Nurse Practitioner | 5302 Chippewa Street, Suite 301, St Louis, MO 63109 | 2017-04-13 |
| 1215362124 | Alex Sharifian Dds Francis Park Dentistry PC | Dentist | 6650 Chippewa Street, Saint Louis, MO 63109 | 2013-09-10 |
| 1881993962 | Rachel Elizabeth Hale Hasper | Counselor | 6555 Chippewa, St Louis, MO 63109 | 2011-03-15 |
| 1730369885 | Janis Marie Lampa | Physical Therapist | 5203 Chippewa, Suite 301, St. Louis, MO 63109 | 2007-11-06 |
| 1285753772 | James Matthew Jordan | Occupational Therapist | 32 Hampton Village Plaza, St Louis, MO 63109 | 2007-03-28 |
| 1730224478 | Mercy Health Services, LLC | Optometrist | 34 Hampton Village Plaza, St. Louis, MO 63109 | 2007-02-20 |
| 1801959903 | John Thomas Doyle | Dentist | 5400 Walsh St, St Louis, MO 63109 | 2006-12-19 |
| 1649339771 | Residencial Services Corporation | Assisted Living Facility | 5890 Eichelberger, St Louis, MO 63109 | 2006-12-06 |
| 1316039852 | Gary Raymond Rieser | Dentist | 3915 Watson Road, Suite 205, Saint Louis, MO 63109 | 2006-09-29 |
| Find all providers in zip 63109 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689203390 | Kathleen Rippe Dowd | Nurse Practitioner | 59 Pointer Ln, Saint Louis, MO 63124-2018 | 2020-04-04 |
| 1871126391 | Kelsey Lonergan | Nurse Practitioner | 10915 Three Court Dr, Saint Louis, MO 63123-5959 | 2020-02-13 |
| 1003383324 | Jennifer Marie Jacobi | Nurse Practitioner | 1 Childrens Pl Fl 12, Saint Louis, MO 63110-1002 | 2018-10-24 |
| 1114381563 | Kathleen B Shaughnessy | Nurse Practitioner | 9580 Watson Rd, Ste A, Saint Louis, MO 63126-1539 | 2016-04-12 |
| 1396117636 | Erika Kircher | Nurse Practitioner | 518 Gray Ave, Saint Louis, MO 63119-3742 | 2015-10-27 |
| 1780007963 | Michelle Marie Dupont | Nurse Practitioner | 1465 South Grand Boulevard, Saint Louis, MO 63104 | 2014-01-24 |
| 1083924468 | Carrie Anne Thrasher | Nurse Practitioner | 3915 Watson Rd Ste 202, Saint Louis, MO 63109-1251 | 2010-10-19 |
| 1265768576 | Cheryl L Grave | Nurse Practitioner | 607 S New Ballas Rd Ste 2415, Saint Louis, MO 63141-8234 | 2009-10-20 |
| 1467639781 | Dana Joann Aronin | Nurse Practitioner | 77 Progress Parkway, Biomedical Systems, Saint Louis, MO 63110-1002 | 2008-01-29 |
| 1265643282 | Dawn Lee Garzon | Nurse Practitioner | 8888 Ladue Rd Ste 100, Saint Louis, MO 63124-2056 | 2007-05-24 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63109 |
Please comment or provide details below to improve the information on MS. ANDREA N MCCULLOCH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.