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KIM CALLICUTT

Personal Care Attendant >> Technician >> Nursing Service Related Providers

Registrant NPI Number: 1245791094

Individual Registrant:
 KIM  CALLICUTT 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
110 BLOCK ST  MARION, AR 72364-1956 US
Tel: 870-636-9593  Fax: --

Contact information for business:
125 ALLEN CV  MARION, AR 72364-8001 US
Tel: 870-636-9593  Fax: 870-559-2803

Registration Information:
NPI: 1245791094
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3747P1801XNursing Service Related Providers
Technician
Personal Care Attendant
AR225320732

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
225320732AR05




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