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1538648811
TARA LYNN MCCULLOUGH
SAINT PAUL, MN
NPI
1538648811
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MN 5944)
Enumeration Date
2018-08-08
Last Update Date
2024-10-30
Business Address
TARA LYNN MCCULLOUGH CNP
2004 FORD PKWY
SAINT PAUL, MN 55116-1931
Phone number: 612-256-8225
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Mailing Address
TARA LYNN MCCULLOUGH CNP
2004 FORD PKWY
SAINT PAUL, MN 55116-1931
Phone number: 612-256-8225
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