Provider Demographics
NPI:1669867248
Name:CULVER, CRAIG
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:CULVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 23RD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-1115
Mailing Address - Country:US
Mailing Address - Phone:303-245-0123
Mailing Address - Fax:303-245-0119
Practice Address - Street 1:850 23RD AVE STE A
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-1115
Practice Address - Country:US
Practice Address - Phone:303-245-0123
Practice Address - Fax:303-245-0119
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN0115980163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse