Provider Demographics
NPI:1598948689
Name:CULLINS, BILLIE JO (LPN)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:JO
Last Name:CULLINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 EXPO CIR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71292-9495
Mailing Address - Country:US
Mailing Address - Phone:318-812-6147
Mailing Address - Fax:318-329-9091
Practice Address - Street 1:213 EXPO CIR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71292-9495
Practice Address - Country:US
Practice Address - Phone:318-812-6147
Practice Address - Fax:318-329-9091
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA220343164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse