Healthcare Provider Details

I. General information

NPI: 1235943200
Provider Name (Legal Business Name): ALYSSA BREANNA MCCULLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2025
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 ARRINGDON PARK DR STE 430
MORRISVILLE NC
27560-5677
US

IV. Provider business mailing address

2732 BLANCHE DR
BURLINGTON NC
27215-5456
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-2471
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number5021602
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: