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Individual

AUTUMN CULLISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 464-2966
Mailing address
23453 COVERED BRIDGE RD, ATHENS, IL 62613-7606

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209028286
IL

Other

Enumeration date
08/29/2022
Last updated
09/20/2023
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