1134441991 NPI number — DENISE MONCIVAIS CULPEPPER LVN

Table of content: DENISE MONCIVAIS CULPEPPER LVN (NPI 1134441991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134441991 NPI number — DENISE MONCIVAIS CULPEPPER LVN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CULPEPPER
Provider First Name:
DENISE
Provider Middle Name:
MONCIVAIS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LVN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MONCIVAIS
Provider Other First Name:
DENISE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LVN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134441991
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2119 SWEET BAY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYTOWN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77523-9433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-383-3208
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
USA MEDDAC BAVARIA
Provider Second Line Business Practice Location Address:
CMR 411, BLDG 700, ROSE BARRACKS
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
011499662834719
Provider Business Practice Location Address Fax Number:
011499662834721
Provider Enumeration Date:
02/22/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 164X00000X , with the licence number:  199848 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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