MEDICARE: MRS. SHANNON LEIGH CULLER MSN, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	005001455	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326118589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHANNON LEIGH CULLER MSN, FNP-BC

Provider Business Mailing Address
First Line	:	309 E CORNWALLIS DR
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27408-5103
Country	:	US
Telephone Number	:	336-274-0179
Fax Number	:

Provider Business Practice Location Address
First Line	:	469 CC CAMP RD
Second Line	:
City	:	ELKIN
State	:	NC
Zip	:	28621-8833
Country	:	US
Telephone Number	:	336-530-1011
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	04/26/2026

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