Basic Information
| Provider Information | |||||||||
| NPI: | 1659782118 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CULVER | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DNP, CPNP-PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5983 E GRANT RD | ||||||||
| Address2: | SUITE 117 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857122365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203207999 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5983 E GRANT RD | ||||||||
| Address2: | SUITE 117 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857122365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203207999 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2014 | ||||||||
| LastUpdateDate: | 07/15/2016 | ||||||||
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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 | 163WP0200X | RN161820 | AZ | N | Nursing Service Providers | Registered Nurse | Pediatrics | 363LP0200X | AP7301 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.