Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207ND0900X | Dermatopathologist | 045886 | CT |
N | 207ND0900X | Dermatopathologist | 11649 | NV |
N | 207ND0900X | Dermatopathologist | 12960 | NH |
Y | 207ND0900X | Dermatopathologist | 217360 | MA |
N | 207ND0900X | Dermatopathologist | 37485 | AZ |
N | 207ND0900X | Dermatopathologist | 6291615 | NY |
NPI | 1669436952 |
---|---|
Provider Name | Dr. Keliegh Suzanne Culpepper |
First Address | Tucson, AZ 85715-3477 |
Second Address | Tucson, AZ 85715-3477 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 06/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9787194 | (05) | MA |
H88305 | (02) | MA |