Provider Demographics
NPI:1013761808
Name:MCCULLEN, ABBIE LYNN
Entity Type:Individual
Prefix:
First Name:ABBIE
Middle Name:LYNN
Last Name:MCCULLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MCNINCH LN
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:14813-1144
Mailing Address - Country:US
Mailing Address - Phone:814-558-7662
Mailing Address - Fax:
Practice Address - Street 1:6 MCNINCH LN
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NY
Practice Address - Zip Code:14813-1144
Practice Address - Country:US
Practice Address - Phone:814-558-7662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach