Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | ||
Y | 176B00000X | Midwife | 90 | TN |
NPI | 1366716706 |
---|---|
Provider Name | Mrs. Karon Annette Culp |
First Address | Cartersville, GA 30120-1149 |
Second Address | East Ridge, TN 37412-1847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2012 |
Last Update Date | 12/07/2021 |