# KATRINA MCCULLOUGH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1881159713
- **Gender:** F
- **Credential:** TRANSPORTATION

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 172A00000X | Driver | K02176486 | KS | Yes |

## Other

- **Enumeration date:** 02/05/2019
- **Last updated:** 02/05/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 83-3421497 | IRS | KS |
| 01 | — | 833421497 | IRS | KS |