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General NPI Number Information
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NPI Number | 1013096460
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Entity Type | Individual
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Provider Name | LISA GAIL CULLITON APRN, BSN, MSN
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1201 MAGNOLIA CT
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City | MOORE
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State | OK
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Zip | 73160-1394
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Country | US
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Telephone | 405-857-7681
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 720686
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City | NORMAN
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State | OK
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Zip | 73070-4522
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Country | US
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Telephone | 405-857-7681
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 209314
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License Number State | OK
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