Provider Demographics
NPI:1922390707
Name:CULVER, VICKI ROSE (RN)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:ROSE
Last Name:CULVER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 BOWES RD
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5541
Mailing Address - Country:US
Mailing Address - Phone:847-931-6200
Mailing Address - Fax:847-888-6079
Practice Address - Street 1:1135 BOWES RD
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5541
Practice Address - Country:US
Practice Address - Phone:847-931-6200
Practice Address - Fax:847-888-6079
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-266193163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult