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

Mrs. Susan Elyse McCullough, FNP

Individual provider Family Nurse Practitioner · NPI 1518583129

Mrs. Susan Elyse McCullough, FNP is a Nurse Practitioner in Southaven, Mississippi. Qualified in 2019, 7 years ago. Practices with Baptist Memorial Medical Group, Inc, a 571-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Mississippi and Tennessee.

Years since qualifying
7
Licensed in
MS, TN
In the registry since
2020
Specialties on file
2
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

7736 Airways Blvd
Southaven, MS 38671-5306
Phone: (662) 772-5222
Fax: (662) 772-5957
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2100 Exeter Rd, Germantown, TN 38138-3966 — (901) 757-1350

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 903762 (MS)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 27393 (TN)

Record details

NPI number1518583129
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedJune 19, 2020
Last updated in NPPESApril 19, 2022
Certification dateApril 19, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Baptist Memorial Medical Group, Inc. — 571 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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