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Individual

MS. JACLYN M CULVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
3920 S DUPONT SQ, STE C, LOUISVILLE, KY 40207-4615
(812) 282-3899
(812) 282-4172
Mailing address
3920 S DUPONT SQ, STE C, LOUISVILLE, KY 40207-4615
(812) 282-3899
(812) 282-4172

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1098624
KY
163W00000X
Registered Nurse
28193680A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
3003956
KY
363LW0102X
Women's Health Nurse Practitioner
3003956
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100069160
KY
01
P00685745
RAILROAD MEDICARE
KY
01
P00895264
RAILROAD MEDICARE
KY
Enumeration date
02/06/2007
Last updated
05/14/2015
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