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General NPI Number Information
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NPI Number | 1649871682
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Entity Type | Individual
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Provider Name | KATHERINE RAE KULUZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 3101 DENNY AVE STE 210
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City | PASCAGOULA
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State | MS
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Zip | 39581-5307
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Country | US
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Telephone | 288-095-3552
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Fax |
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Provider Business Mailing Address
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Address Line | 735 BUDDELIA CV
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City | BILOXI
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State | MS
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Zip | 39532-4118
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00512
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License Number State | MS
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