Provider Demographics
NPI:1366716706
Name:CULP, KARON ANNETTE (CPM, CLC, CD(DONA))
Entity type:Individual
Prefix:MRS
First Name:KARON
Middle Name:ANNETTE
Last Name:CULP
Suffix:
Gender:F
Credentials:CPM, CLC, CD(DONA)
Other - Prefix:MISS
Other - First Name:KARON
Other - Middle Name:ANNETTE
Other - Last Name:SLAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1149
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-1149
Mailing Address - Country:US
Mailing Address - Phone:678-431-0500
Mailing Address - Fax:
Practice Address - Street 1:3605 WIMBERLY LN
Practice Address - Street 2:
Practice Address - City:EAST RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37412-1847
Practice Address - Country:US
Practice Address - Phone:865-936-5455
Practice Address - Fax:678-433-2088
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-02
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X, 174N00000X, 374J00000X
TN90176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula