Provider Demographics
NPI:1376787580
Name:CULPEPPER, ANGELA B (ARNP, FNP, BC)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:B
Last Name:CULPEPPER
Suffix:
Gender:F
Credentials:ARNP, FNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 NE COLIN KELLY HWY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340-5187
Mailing Address - Country:US
Mailing Address - Phone:850-973-0341
Mailing Address - Fax:
Practice Address - Street 1:1702 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32348-5611
Practice Address - Country:US
Practice Address - Phone:855-577-5437
Practice Address - Fax:850-838-2140
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1188462363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001157000Medicaid