Individual
CALEB P CULBREATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(636) 386-7222
Mailing address
PO BOX 22407, SAINT LOUIS, MO 63126-0407
(636) 386-7222
(636) 386-7810
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2024017556
MO
367500000X
Certified Registered Nurse Anesthetist
209030323
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16145517
CAQH ID
—
01
—
209030323
IDPR
IL
Enumeration date
08/11/2023
Last updated
11/15/2024
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