Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Samantha Lynn McCullough, FNP-C

Individual provider Registered Nurse · NPI 1003542168

Samantha Lynn McCullough, FNP-C is a Nurse Practitioner in Owasso, Oklahoma. Qualified in 2022, 4 years ago. Practices with Medwise LLC, a 33-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
4
Licensed in
OK
In the registry since
2022
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

10728 N 152nd East Ave
Owasso, OK 74055-6384
Phone: (918) 914-0675
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 209493 (OK)
Registered Nurse Taxonomy 163W00000X · Licence R0124315 (OK)

Record details

NPI number1003542168
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedJuly 29, 2022
Last updated in NPPESJuly 29, 2022
Certification dateJuly 29, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Medwise Llc — 33 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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