Individual
KATHRYN CULLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5433 W WALSH LN, ROGERS, AR 72758-8946
(479) 777-8014
Mailing address
105 JENNA LN, GRAVETTE, AR 72736-5019
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-1242
AR
Other
Enumeration date
01/19/2024
Last updated
02/01/2024
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