SHANNON P KUKULKA APRN NPI 1982072591

NPI Information

NPI: 1982072591
Provider Name: SHANNON P KUKULKA, APRN
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
874 HOWARD AVE
NEW HAVEN, CT
ZIP 06519
Phone: (203) 688-8200
Get Directions

Shannon P Kukulka, APRN is a gerontology nurse practitioner in New Haven, CT. Shannon P Kukulka, APRN NPI is 1982072591. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

874 HOWARD AVE
NEW HAVEN, CT
ZIP 06519-106
Phone: (203) 688-8200
Fax: (203) 688-8200

The NPI 1982072591 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/14/2015 and was last updated on 1/3/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	6878	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1982072591	OTHER	CONNECTICUT	ANTHEM
2	P5602305	OTHER	CONNECTICUT	OXFORD
3	AA533003	OTHER	CONNECTICUT	HARVARD PILGRIM
4	1982072591	MEDICAID	CONNECTICUT
5	1982072591	OTHER	CONNECTICUT	MULTIPLAN
6	4869372	OTHER	CONNECTICUT	AETNA
7	6028631	OTHER	CONNECTICUT	CIGNA
8	1982072591	OTHER	CONNECTICUT	UNITED HEALTHCARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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