Provider Demographics
NPI:1790756278
Name:CULVER, JOLENE (ARNP, CRNFA)
Entity Type:Individual
Prefix:MS
First Name:JOLENE
Middle Name:
Last Name:CULVER
Suffix:
Gender:F
Credentials:ARNP, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92302 E HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-8336
Mailing Address - Country:US
Mailing Address - Phone:509-378-4227
Mailing Address - Fax:
Practice Address - Street 1:92302 E HOLLY RD
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-8336
Practice Address - Country:US
Practice Address - Phone:509-378-4227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00163114163WR0006X
WAAP60310239363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8934176Medicare UPIN