Provider Demographics
NPI:1417211814
Name:CULP, JUDITH MAY
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:MAY
Last Name:CULP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 CENTENNIAL LOOP
Mailing Address - Street 2:SUITE 3
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2471
Mailing Address - Country:US
Mailing Address - Phone:541-344-7789
Mailing Address - Fax:541-342-8491
Practice Address - Street 1:81 CENTENNIAL LOOP
Practice Address - Street 2:SUITE 3
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2471
Practice Address - Country:US
Practice Address - Phone:541-344-7789
Practice Address - Fax:541-342-8491
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OREPT-T-222466246ZA2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical