Mccullough, Ellen J
Mccullough, Ellen J is an individual health care provider with primary practice located at 1210 1St St W , Hastings MN 55033-1147. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mccullough, Ellen J can be contacted via phone (651) 438-1800.Contact Information
Primary practice address
1210 1St St W
Hastings MN 55033-1147
Phone: (651) 438-1800
Fax: (651) 438-1894
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 9060 | Minnesota |
Profile Details
| NPI number | 1417910472 |
|---|---|
| LBN Legal business name | Mccullough, Ellen J |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 10th, 2006 |
| Last updated | Mar 11th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417910472 | NPPES |
| Minnesota | MEDICAID | 181516400 |
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