Provider Demographics
NPI:1073502340
Name:KULB, NANCY WRIGHT (CNM)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:WRIGHT
Last Name:KULB
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 AIRPORT BLVD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-9075
Mailing Address - Country:US
Mailing Address - Phone:850-476-3696
Mailing Address - Fax:850-477-3573
Practice Address - Street 1:2114 AIRPORT BLVD
Practice Address - Street 2:SUITE 1000
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-9075
Practice Address - Country:US
Practice Address - Phone:850-476-3696
Practice Address - Fax:850-477-3573
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2017952367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY8896OtherBCBSFL
FL300815100Medicaid
FL59088938OtherBCBS AL
FLP00105297OtherMEDICARE RR
FL300815100Medicaid
S90422Medicare UPIN