Healthcare Provider Details

I. General information

NPI: 1750592309
Provider Name (Legal Business Name): NANCY CULP PAPIERNIAK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY MARIE CULP D.O.

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 01/26/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 SW 130TH WAY SUITE I
TIOGA FL
32669-0015
US

IV. Provider business mailing address

133 SW 130TH WAY SUITE I
TIOGA FL
32669-0015
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-3838
  • Fax: 352-333-3887
Mailing address:
  • Phone: 352-333-3838
  • Fax: 352-333-3887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS9882
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: