| NPI | 1790393049 |
|---|---|
| Other Name | KATHY MCCULLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2020006141) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO F12190784) |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2020-07-22 |