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
Mailing address11873 63rd Pl N, Maple Grove, MN 55369-6152

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