Mcculloch, Mary Elizabeth

Mcculloch, Mary Elizabeth is an individual health care provider with primary practice located at 190 E Bannock St , Boise ID 83712-6241. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care, which is considered as her primary health care specialty. Mcculloch, Mary Elizabeth can be contacted via phone (208) 381-2088.

Contact Information

Primary practice address
190 E Bannock St Boise ID 83712-6241
Phone: (208) 381-2088
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care 363LN0005X 58268 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care 363LN0005X 2203014405 Utah

Profile Details

NPI number 1275672396
LBN Legal business name Mcculloch, Mary Elizabeth
Credentials NNP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Aug 29th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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