Individual
MISS CONNIE GULLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
231 SAINT MARYS LN, WAVERLY, OH 45690-1052
(740) 970-0576
Mailing address
231 SAINT MARYS LN, WAVERLY, OH 45690-1052
(740) 970-0576
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN114566
OH
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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