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General NPI Number Information
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NPI Number | 1275897639
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Entity Type | Individual
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Provider Name | SARAH LINDSEY MCCULLOUGH CNM, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/30/2012
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 701 PARK AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55415-1623
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Country | US
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Telephone | 612-873-2203
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Fax |
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Provider Business Mailing Address
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Address Line | 701 PARK AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55415-1623
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Country | US
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Telephone | 612-873-2203
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Fax | 651-222-1305
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R210681-8
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP1180
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | CNM0123
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License Number State | MN
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