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General NPI Number Information
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NPI Number | 1114463981
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Entity Type | Individual
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Provider Name | LADONNA CULP APRN
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Gender | Female
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Dates
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Enumeration Date | 01/17/2017
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Last Update Date | 05/16/2017
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Provider Practice Location Address
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Address Line | 311 LAFITTE ST
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City | TISHOMINGO
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State | OK
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Zip | 73460-2433
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Country | US
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Telephone | 580-387-9006
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Fax |
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Provider Business Mailing Address
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Address Line | 311 LAFITTE ST
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City | TISHOMINGO
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State | OK
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Zip | 73460-2433
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Country | US
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Telephone | 580-387-9006
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 96158
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 96158
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License Number State | OK
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