Provider Demographics
NPI:1386107407
Name:CULPEPPER, CARRIE DIANNE (APRN)
Entity type:Individual
Prefix:MISS
First Name:CARRIE
Middle Name:DIANNE
Last Name:CULPEPPER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21346 SAINT ANDREWS BLVD # 121
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-2432
Mailing Address - Country:US
Mailing Address - Phone:561-221-6895
Mailing Address - Fax:
Practice Address - Street 1:7301A W PALMETTO PARK RD STE 100B
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3403
Practice Address - Country:US
Practice Address - Phone:561-221-6895
Practice Address - Fax:561-221-6896
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001595363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care