Individual
KATHLEEN ROSE MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4525 CAMERON VALLEY PKWY, STE 4100, CHARLOTTE, NC 28211-4369
(704) 355-5100
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-07415
NC
Other
Enumeration date
12/10/2012
Last updated
07/15/2024
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