Individual
MRS. KATHLEEN ANN MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNFA
Contact information
Practice address
RR 11 BOX 923, JACKSONVILLE, TX 75766-9882
(903) 721-2274
(903) 586-2379
Mailing address
PO BOX 2531, JACKSONVILLE, TX 75766-0069
(903) 721-2274
(903) 586-2379
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
572813
TX
Other
Enumeration date
02/24/2006
Last updated
07/08/2007
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