Healthcare Provider Details

I. General information

NPI: 1417568692
Provider Name (Legal Business Name): BILLIE R CULL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 06/23/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 WEST WALNUT ROAD
WHITMAN WV
25652
US

IV. Provider business mailing address

318 WEST WALNUT ROAD
WHITMAN WV
25652
US

V. Phone/Fax

Practice location:
  • Phone: 304-896-2061
  • Fax:
Mailing address:
  • Phone: 304-896-2061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: