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Individual

MATTHEW CULBRETH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
301 GORDON GUTMANN BLVD STE 101, JEFFERSONVILLE, IN 47130-3765
(812) 282-4844
(812) 282-6248
Mailing address
2608 WOODSDALE AVE, LOUISVILLE, KY 40220
(812) 756-6029

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3017889
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71011143A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
196290262
MEDICARE
IN
05
300058907
KY
05
7100766380
IN
Enumeration date
06/08/2021
Last updated
04/03/2024
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