Individual
KEISHA TULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3054 W POPLAR RIDGE RD NW, MALTA, OH 43758-9682
(740) 973-0058
(740) 962-3351
Mailing address
3054 W POPLAR RIDGE RD NW, MALTA, OH 43758-9682
(740) 973-0058
(740) 962-3351
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
319249
OH
Other
Enumeration date
02/12/2010
Last updated
02/12/2010
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