Provider Demographics
NPI:1194312496
Name:CULLOP, MEREDITH ASHLEY OLDHAM (NP)
Entity type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:ASHLEY OLDHAM
Last Name:CULLOP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:ASHLEY
Other - Last Name:OLDHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3706 S ROCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-7708
Mailing Address - Country:US
Mailing Address - Phone:336-847-7650
Mailing Address - Fax:
Practice Address - Street 1:121 BROAD ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-2725
Practice Address - Country:US
Practice Address - Phone:276-781-5900
Practice Address - Fax:276-782-9153
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013897363LF0000X, 208VP0000X
VA0024187902363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily