Mccullough, Lori A
Mccullough, Lori A is an individual health care provider with primary practice located at 4500 Memorial Dr , Belleville IL 62226-5360. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Mccullough, Lori A can be contacted via phone (618) 257-6220.Contact Information
Primary practice address
4500 Memorial Dr
Belleville IL 62226-5360
Phone: (618) 257-6220
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 2002001000 | Missouri |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 085005433 | Illinois |
Profile Details
| NPI number | 1336312693 |
|---|---|
| LBN Legal business name | Mccullough, Lori A |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 8th, 2008 |
| Last updated | Aug 31st, 2022 - about 3 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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