Mccullum, Peggy Lisa

Mccullum, Peggy Lisa is an individual health care provider with primary practice located at 3640 Nw Samaritan Dr Ste 220 , Corvallis OR 97330-3784. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, Other Service Providers / Midwife. Other Service Providers / Midwife is her primary health care specialty. Mccullum, Peggy Lisa can be contacted via phone (541) 768-5300.

Contact Information

Primary practice address
3640 Nw Samaritan Dr Ste 220 Corvallis OR 97330-3784
Phone: (541) 768-5300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 200450148NP Oregon
Other Service Providers / Midwife 176B00000X 200450148NP Oregon

Profile Details

NPI number 1528005253
LBN Legal business name Mccullum, Peggy Lisa
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2006
Last updated Nov 10th, 2020 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1528005253 NPPES
Oregon Other 200450148NP STATE LICENSE
Oregon Other 200442216RN STATE LICENSE
Oregon MEDICAID 269512 STATE LICENSE

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