Provider Demographics
NPI:1134441991
Name:CULPEPPER, DENISE MONCIVAIS (LVN)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MONCIVAIS
Last Name:CULPEPPER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:MONCIVAIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:2119 SWEET BAY ST
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77523-9433
Mailing Address - Country:US
Mailing Address - Phone:281-383-3208
Mailing Address - Fax:
Practice Address - Street 1:USA MEDDAC BAVARIA
Practice Address - Street 2:CMR 411, BLDG 700, ROSE BARRACKS
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09112
Practice Address - Country:US
Practice Address - Phone:01149966-283-4719
Practice Address - Fax:01149966-283-4721
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX199848164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADOOMedicare UPIN