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General NPI Number Information
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NPI Number | 1720944143
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Entity Type | Individual
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Provider Name | KIRA MCCULLY
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Gender | Female
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 1260 ELM ST
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City | MANCHESTER
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State | NH
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Zip | 03101-1354
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Country | US
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Telephone | 609-703-9214
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Fax |
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Provider Business Mailing Address
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Address Line | 213 PEQUOT AVE
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City | MYSTIC
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State | CT
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Zip | 06355-1739
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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