Nicole Elisabeth McCullough, PA-C
Physician Assistant, Medical in Swartz Creek, MI. Individual provider (NPI-1).
NPI number1497388441
StatusActive
Last updated in NPPESApr 7, 2021
Details
- NPI
- 1497388441
- Entity type
- Individual (NPI-1)
- Name
- Nicole Elisabeth McCullough
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 18, 2020
- Certification date
- Apr 7, 2021
- Last updated
- Apr 7, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 5601009723 | MI | Yes |
Other names
- Nicole Elisabeth Giddey (Former Name)
Practice location
5296 Greenleaf DrSwartz Creek, MI 48473-1165
Phone 586-488-8610
Mailing address
5296 Greenleaf DrSwartz Creek, MI 48473-1165
Phone 586-488-8610
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