Most Relevant Information
Provider Data
| NPI Number: | 1003371923 |
| Provider Name: | CULLEN WHICKER CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 209018652 |
Most Important Dates
| Enumeration Date: | 02/05/2019 |
| Last Updated: | 02/05/2019 |
Provider Practice Location
2300 N EDWARD ST
DECATUR
IL
625264192
Practice Location Phone/Fax
| Phone: | 2178762575 |
| Fax: |
Provider Mailing Location
304 COREY LN
CHAMPAIGN
IL
618221130
Provider Mailing Phone/Fax
| Phone: | 2179724546 |
| Fax: |