Mccullough, Tina L
Mccullough, Tina L is an individual health care provider with primary practice located at 1330 Clark St , Cambridge OH 43725-9614. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mccullough, Tina L can be contacted via phone (740) 421-9530.Contact Information
Primary practice address
1330 Clark St
Cambridge OH 43725-9614
Phone: (740) 421-9530
Fax: (740) 421-9531
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | COA.12918-NP | Ohio |
Profile Details
| NPI number | 1558636332 |
|---|---|
| LBN Legal business name | Mccullough, Tina L |
| Credentials | NP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 13th, 2012 |
| Last updated | Oct 9th, 2015 - about 10 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 | 1558636332 | NPPES |
| Ohio | MEDICAID | 0062479 |
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