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Individual

JANET MCCULLOUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
129 TOM COVE, SHANNON, MP 38868
(662) 871-7045
Mailing address
129 TOM CV, SHANNON, MS 38868-6004
(662) 871-7045

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P327026
MS

Other

Enumeration date
08/19/2015
Last updated
08/19/2015
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