Healthcare Provider Details
I. General information
NPI: 1477565331
Provider Name (Legal Business Name): DAVID A CULP FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/12/2006
Last Update Date: 05/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1325 LOUISVILLE AVE
MONROE LA
71201-6021
US
IV. Provider business mailing address
130 DESIARD ST SUITE 355
MONROE LA
71201-7319
US
V. Phone/Fax
- Phone: 318-807-1500
- Fax: 318-807-1504
- Phone: 318-807-7875
- Fax: 318-812-6603
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN083881 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | AP03700 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: