| NPI | 1932083011 |
|---|---|
| Former Name | ELIZABETH MARLO MCCULLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5022764) |
| Enumeration Date | 2025-08-02 |
| Last Update Date | 2025-08-08 |