Provider Demographics
NPI:1225048556
Name:CULP, DAVID (NP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:CULP
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 N CANYON ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-5816
Mailing Address - Country:US
Mailing Address - Phone:575-234-1644
Mailing Address - Fax:
Practice Address - Street 1:608 N CANYON ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5816
Practice Address - Country:US
Practice Address - Phone:575-234-1644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COR57579363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00NM006E30OtherBCBS
NM57008558Medicaid
NM343628503Medicare PIN