Provider Demographics
NPI:1962227819
Name:CULLUM, PAMELA (RN, CMM, DOULA)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:CULLUM
Suffix:
Gender:F
Credentials:RN, CMM, DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2342 ANDRE LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-7896
Mailing Address - Country:US
Mailing Address - Phone:707-331-2980
Mailing Address - Fax:707-526-7314
Practice Address - Street 1:2342 ANDRE LN
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-7896
Practice Address - Country:US
Practice Address - Phone:707-331-2980
Practice Address - Fax:707-526-7314
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-16
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty