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Individual

DR. JOHANNA LYNN MCCULLAGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4320 WORNALL RD, SUITE 208, KANSAS CITY, MO 64111-5941
(816) 531-0552
(816) 756-2503
Mailing address
4320 WORNALL RD, SUITE 208, KANSAS CITY, MO 64111-5941
(816) 531-0552
(816) 756-2503

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0431432
KS
207RN0300X
Nephrology Physician
Primary
04-31432
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04-31432
KSLICENSE
KS
Enumeration date
01/31/2007
Last updated
03/09/2016
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