Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Colleen McCullough

Individual provider Athletic Trainer · NPI 1104204726

Colleen McCullough is an Athletic Trainer in Maple Grove, Minnesota. Practices as a sole proprietor. Registered with an NPI since 2015.

In the registry since
2015
Specialties on file
2
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Practice location Address checks out

11873 63rd Pl N
Maple Grove, MN 55369-6152
Phone: (763) 227-9791
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1104204726
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 14, 2015
Last updated in NPPESMay 14, 2015

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