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NPI Code Detail

MEDICARE: MARION LORRAINE CULBERTSON NP

MEDICARE:   MARION LORRAINE CULBERTSON  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerWV42604WV

Other Identifiers

General Provider Information

NPI Number : 1629067905
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARION LORRAINE CULBERTSON NP
Provider Business Mailing Address
First Line : 2910 EMERSON AVE
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-2519
Country : US
Telephone Number : 304-428-1900
Fax Number : 304-428-1976
Provider Business Practice Location Address
First Line : 2910 EMERSON AVE
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-2519
Country : US
Telephone Number : 304-428-1900
Fax Number : 304-428-1976
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2005
Last Update Date : 07/09/2007

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Directions to “ MARION LORRAINE CULBERTSON NP” Practice Location

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