Healthcare Provider Details

I. General information

NPI: 1922413962
Provider Name (Legal Business Name): ERIKA KIMBERLY CULLOP APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2014
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 JUPITER LAKES BLVD STE 200
JUPITER FL
33458-7100
US

IV. Provider business mailing address

770 NORTHPOINT PKWY STE 102
WEST PALM BEACH FL
33407-1901
US

V. Phone/Fax

Practice location:
  • Phone: 561-741-1957
  • Fax: 561-275-7547
Mailing address:
  • Phone: 561-802-5357
  • Fax: 561-275-7547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9296630
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAPRN9296630
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: