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Individual

CULLEN TOMME SHOWS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5360 I 55 N STE 150, JACKSON, MS 39211-4055
(601) 345-8200
Mailing address
PO BOX 301, STAR, MS 39167-0301
(601) 382-6325

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
915744
MS
363LP2300X
Primary Care Nurse Practitioner
Primary
906955
MS

Other

Enumeration date
04/21/2023
Last updated
09/30/2024
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