Mccullen, Kim Lee

Mccullen, Kim Lee is an individual health care provider with primary practice located at 22101 Moross Rd , Detroit MI 48236-2148. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care, Physician Assistants & Advanced Practice Nursing Providers / Neonatal. Physician Assistants & Advanced Practice Nursing Providers / Neonatal is her primary health care specialty. Mccullen, Kim Lee can be contacted via phone (313) 343-4400.

Contact Information

Primary practice address
22101 Moross Rd Detroit MI 48236-2148
Phone: (313) 343-4400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care 363LN0005X 4704207081 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 4704207081 Michigan

Profile Details

NPI number 1609029289
LBN Legal business name Mccullen, Kim Lee
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2008
Last updated Sep 14th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609029289 NPPES
Michigan Other 4704207081 BLUE CROSS GROUP 0N11180

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