NPI | 1134560691 |
---|---|
Former Name | SUSAN KAY MCCULLAH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 23120) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 23120) |
Enumeration Date | 2013-07-12 |
Last Update Date | 2025-07-02 |