Dominise Mccullough, RN

NPI #1013378553 in Madison, Wisconsin

Provider Information

NPI Number: 1013378553
Entity Type: Individual
Name: Dominise Mccullough, RN
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Registered Nurse
Credential: RN
Enumeration Date: Mar 11, 2016
Last Updated: Nov 22, 2019

Practice Location

Address: 2718 OLD CAMDEN SQ
City: Madison
State: Wisconsin
ZIP Code: 53718-7954
Phone: (608) 514-5697

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Licensed Practical Nurse	164W00000X
Registered Nurse	163W00000X	Primary

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