| NPI | 1790130797 |
|---|---|
| Former Name | KATHLEEN ELYSE MCCULLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.19238) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH RN.390686-) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2020-06-03 |