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1114533825
KEVAN PATRICK MCCULLUM
LOUISVILLE, KY
NPI
1114533825
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: KY 3015146)
Enumeration Date
2020-09-17
Last Update Date
2020-09-22
Business Address
KEVAN PATRICK MCCULLUM APRN
908 DUPONT RD
LOUISVILLE, KY 40207-4602
Phone number: 502-749-7909
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Mailing Address
KEVAN PATRICK MCCULLUM APRN
PO BOX 909
LOUISVILLE, KY 40201-0909
Phone number:
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