Basic Information
| Provider Information | |||||||||
| NPI: | 1073502340 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KULB | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | WRIGHT | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2114 AIRPORT BLVD | ||||||||
| Address2: | SUITE 1000 | ||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325049075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504763696 | ||||||||
| FaxNumber: | 8504773573 | ||||||||
| Practice Location | |||||||||
| Address1: | 2114 AIRPORT BLVD | ||||||||
| Address2: | SUITE 1000 | ||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325049075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504763696 | ||||||||
| FaxNumber: | 8504773573 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2005 | ||||||||
| LastUpdateDate: | 07/29/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | ARNP2017952 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | Y8896 | 01 | FL | BCBSFL | OTHER | 300815100 | 05 | FL | MEDICAID | 59088938 | 01 | FL | BCBS AL | OTHER | P00105297 | 01 | FL | MEDICARE RR | OTHER |