Provider Demographics
NPI:1023756178
Name:CULVER, KINDRELA
Entity type:Individual
Prefix:
First Name:KINDRELA
Middle Name:
Last Name:CULVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 CEDAR SPRINGS RD APT 1614
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202-1217
Mailing Address - Country:US
Mailing Address - Phone:972-514-2840
Mailing Address - Fax:
Practice Address - Street 1:1700 CEDAR SPRINGS RD APT 1614
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75202-1217
Practice Address - Country:US
Practice Address - Phone:972-514-2840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP325077164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse