Kukulka, Shannon P
Kukulka, Shannon P is an individual health care provider with primary practice located at 874 Howard Ave , New Haven CT 06519-1106. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Kukulka, Shannon P can be contacted via phone (203) 688-8200.Contact Information
Primary practice address
874 Howard Ave
New Haven CT 06519-1106
Phone: (203) 688-8200
Fax: (203) 688-8200
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 6878 | Connecticut |
Profile Details
| NPI number | 1982072591 |
|---|---|
| LBN Legal business name | Kukulka, Shannon P |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2015 |
| Last updated | Jan 3rd, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982072591 | NPPES |
| Connecticut | Other | 1982072591 | UNITED HEALTHCARE |
| Connecticut | Other | 1982072591 | UNITED HEALTHCARE |
| Connecticut | Other | 4869372 | UNITED HEALTHCARE |
| Connecticut | Other | 1982072591 | UNITED HEALTHCARE |
| Connecticut | MEDICAID | 1982072591 | UNITED HEALTHCARE |
| Connecticut | Other | AA533003 | UNITED HEALTHCARE |
| Connecticut | Other | P5602305 | UNITED HEALTHCARE |
| Connecticut | Other | 6028631 | UNITED HEALTHCARE |
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