Individual
LAMONICE MARIE MCCULLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
451 HIGHWAY 90, WAVELAND, MS 39576-2507
(228) 400-0055
Mailing address
10580 STEEPLECHASE DR, GULFPORT, MS 39503-4279
(228) 224-7953
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
907308
MS
Other
Enumeration date
03/25/2025
Last updated
03/25/2025
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