Individual provider · NPI-1
Connie Sue Mccullick, APNP
Nurse Practitioner · Madison, WI
NPI number1013358787
StatusActive
Last updated in NPPESSep 14, 2021
Details
- NPI
- 1013358787
- Entity type
- Individual (NPI-1)
- Name
- Connie Sue Mccullick
- Credential
- APNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 10, 2013
- Certification date
- Sep 14, 2021
- Last updated
- Sep 14, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 3628 | WI | Yes |
| 364SA2200X | Clinical Nurse Specialist, Adult Health | 3628 | WI |
Practice location
700 S Park StMadison, WI 53715-1830
Phone 608-251-6100 · Fax 608-260-2951
Mailing address
700 S Park StMadison, WI 53715-1830
Phone 608-251-6100 · Fax 608-260-2951
Other practice locations
1836 South Ave
La Crosse, WI 54601-5429
La Crosse, WI 54601-5429
Phone 608-782-7300
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