Mary Lou McCulley, RN CDE
Individual provider Active NPI Health Educator · Fairfield, IL
NPI 1124494174 · NPPES record last updated Aug 13, 2015
Key facts
- NPI
- 1124494174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Health Educator 174H00000X
- License
- 041359796 (IL)
- Practice address
- 303 NW 11TH St
Fairfield, IL 62837-1203 - Phone
- (618) 842-2611
- Fax
- (618) 847-8388
- NPI assigned
- Aug 13, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041359796 | IL | MD | Health Educator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | 041359796 | IL | Yes |
Addresses
Primary practice location
303 NW 11TH St
Fairfield, IL 62837-1203
Mailing address
303 NW 11TH St
Fairfield, IL 62837-1203
Phone (618) 842-2611
Other providers in Fairfield, IL
- Little Egypt Surgical Assisting L.L.C
- McKenna D Loss
- Melanie S. Maas
- Natalie Maas
- Marion Eye Centers LTD.
- Bethany R Meeks
- Sherry L Mewes
- Midwest Care Fairfield
- Miller Family Dentistry & Implants
- Nancy M. Miller
All providers in Fairfield, IL · Health Educator in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.