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KEIDRA MCCULLOUGH
NPI 1477499101
Specialist in Statesville, NC

Active since April 27, 2026
314 SIGNAL HILL DR, STATESVILLE, NC 28625(704) 450-9104 Get Directions Write a Review

NPPES record last updated: April 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Keidra Mccullough NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEIDRA MCCULLOUGH (NPI 1477499101) is an individual specialist in Statesville, North Carolina, licensed in North Carolina (CT2780) and active in the NPI registry since April 2026.

NPPES Registry Identity

NPI1477499101
Entity TypeIndividual
Primary Taxonomy174400000X
Provider Legal NameKEIDRA MCCULLOUGH
Location Address314 SIGNAL HILL DRStatesville, NC 28625-4357
Mailing Address510 S Meeting StStatesville, NC 28677-6108 · (704) 450-9104
Phone(704) 450-9104
Sole ProprietorNo
Enumeration DateApril 27, 2026
NPPES CertifiedApril 26, 2026
✔ NPI 1477499101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Licenses✔ Licensed in NC · CT2780✔ Licensed in NC · C89143
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
314 SIGNAL HILL DR, Statesville, NC 28625
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHEAR GRACE HAIR STUDIO LLC
Durable Medical Equipment & Medical Supplies
314 SIGNAL HILL DR
STATESVILLE, NC 28625
Iredell County (704) 450-9104

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keidra Mccullough's NPI number?

The NPI number for Keidra Mccullough is 1477499101. It was assigned to this individual provider in the NPPES registry on April 27, 2026.

Where is Keidra Mccullough located?

Keidra Mccullough practices at 314 Signal Hill Dr, Statesville, NC 28625. The listed phone number is (704) 450-9104.

What is Keidra Mccullough's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Keidra Mccullough was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.