Individual
LADONNA CULP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
311 LAFITTE ST, TISHOMINGO, OK 73460-2433
(580) 387-9006
Mailing address
311 LAFITTE ST, TISHOMINGO, OK 73460-2433
(580) 387-9006
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
96158
OK
390200000X
Student in an Organized Health Care Education/Training Program
96158
OK
Other
Enumeration date
01/17/2017
Last updated
05/16/2017
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