SUSAN E MCCULLOUGH (NPI# 1518583129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518583129 |
| Entity Type | Individual |
| Full Name | SUSAN E MCCULLOUGH |
| Credential | FNP |
| Practice Address |
5932 Antler Trl Southaven MS 38672-6511 |
| Practice Telephone | 9194401791 |
| Mailing Telephone | 9194401791 |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2020-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F09191688 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | F09191688 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689923773 | Susan L Mccullough | Registered Nurse | 621 Moull St, Newark, OH 43055-2910 | 2012-09-05 |
| 1881836336 | Susan Elizabeth Mccullough | Social Worker | 700 Front St, Suite 204, Louisville, CO 80027-1805 | 2009-03-30 |
| 1639255581 | Susan Jean Mccullough | Nurse Practitioner | 601 N 30th St, Omaha, NE 68131-2137 | 2006-10-31 |
| Street Address |
5932 ANTLER TRL |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38672-6511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100826 | Sarah Kathryn Pratt | Physical Therapist | 5271 Getwell Road, Suite A, Southaven, MS 38672 | 2020-09-24 |
| 1356713606 | Deadra Dennis | Behavioral Analyst | 2816 Calico Rock Cv, Southaven, MS 38672 | 2015-10-27 |
| 1568727352 | Patricia Leanne Lewis | Family Medicine | 5908 Getwell Rd, Southaven, MS 38672 | 2012-07-09 |
| 1417183922 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2945 Goodman Road East, Southaven, MS 38672 | 2009-06-10 |
| 1568609998 | Susan Orsland | Physical Therapist | 4355 Genevieve Drive, Southaven, MS 38672 | 2009-01-07 |
| 1659516524 | Stacy L Sanders | Audiologist | 5740 Getwell Rd. Building 3 Unit B, Southaven, MS 38672 | 2008-12-08 |
| 1295927226 | Tracey F Petrides | Family Medicine | 5779 Getwell Road, Building D, Suite 3, Southaven, MS 38672 | 2007-08-14 |
| 1538288741 | Bruce A Denney | Dentist | 7125 Getwell Road, Suite 102, Southaven, MS 38672 | 2007-03-28 |
| 1154480150 | Kimberly Marie Metcalf | Social Worker | 7165-g Getwell Rd., Southaven, MS 38672 | 2006-12-06 |
| 1346318441 | Deborah Verucchi | Nurse Practitioner | 5740 Getwell Rd Ste B, Southaven, MS 38672 | 2006-11-30 |
| Find all providers in zip 38672 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615616 | Jack Chandler Papa | Nurse Practitioner | 3556 May Brook Cv, Southaven, MS 38672-1006 | 2020-09-26 |
| 1336764778 | Raquel Janay Reed-washington | Nurse Practitioner | 3548 Herbert Cv, Southaven, MS 38672-2003 | 2020-06-11 |
| 1104452887 | Vincent Lee Spinosa-parker | Nurse Practitioner | 5056 Maiden Lane Cv, Southaven, MS 38672-6000 | 2020-03-13 |
| 1215438437 | Alba Laura Emerson | Nurse Practitioner | 1862 Lindsey Ln, Southaven, MS 38672-8602 | 2018-02-22 |
| 1629583026 | Lachasity Kimmons | Nurse Practitioner | 2032 Audubon Pl, Southaven, MS 38672-9440 | 2017-12-06 |
| 1124322474 | Ageless Men's Health, LLC | Nurse Practitioner | 7111 Southcrest Pkwy, Suite 109, Southaven, MS 38671-4850 | 2010-12-30 |
| 1487757365 | Regina G Seaton | Nurse Practitioner | 7676 Airways Blvd, Southaven, MS 38671-5304 | 2006-09-06 |
| 1063465482 | Misty Ann Moore | Nurse Practitioner | 7585 Clarington Cove, Southaven, MS 38671-2300 | 2006-05-18 |
| 1184602450 | Tammy Louise Carnahan | Nurse Practitioner | 7900 Airways Blvd, Building A Suite 6, Southaven, MS 38671-4113 | 2006-01-05 |
| 1831728583 | Treneise Hunt-smith | Nurse Practitioner | 340 Stateline Rd W, Southaven, MS 38671-1610 | 2020-04-05 |
| Find all providers in SOUTHAVEN | ||||
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| 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.