Individual
MRS. IRENE KILCULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5412 BOULDER HWY, LAS VEGAS, NV 89122-6039
(702) 291-7121
Mailing address
4140 HAZELRIDGE DR, LAS VEGAS, NV 89129-6542
(818) 261-8416
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/14/2022
Last updated
02/14/2022
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