Mcculley, Betty
Mcculley, Betty is an sole proprietor health care provider with primary practice located at 5344 Trailview Dr , Black Jack MO 63033-4645. She recently has only one registered license in Agencies / Home Health, which is considered as her primary health care specialty. Mcculley, Betty can be contacted via phone (314) 309-7758.Contact Information
Primary practice address
5344 Trailview Dr
Black Jack MO 63033-4645
Phone: (314) 309-7758
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Home Health | 251E00000X |
Profile Details
| NPI number | 1508462391 |
|---|---|
| LBN Legal business name | Mcculley, Betty |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 8th, 2020 |
| Last updated | Dec 8th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508462391 | NPPES |
| Missouri | MEDICAID | 16982862 |
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