Individual
MR. MICAH KELLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
18500 KATY FWY, HOUSTON, TX 77094-1110
(832) 522-1000
Mailing address
30711 SPANISH MOSS XING, FULSHEAR, TX 77441-3709
(713) 560-9519
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP140431
TX
Other
Enumeration date
01/31/2019
Last updated
11/22/2021
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