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Individual
SEAN KOULABOUD
Active
Individual
SEAN KOULABOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN-53-76899
KS
363LF0000X
Family Nurse Practitioner
53-76899
KS
363LF0000X
Family Nurse Practitioner
Primary
95004148
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95004148
CALIFORNIA NURSING LICENSE
CA
01
—
APRN-53-76899
KANSAS NURSING LICENSE
KS
Enumeration date
12/07/2015
Last updated
05/03/2018
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