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:
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Health care specialties

SpecialtyCodeLicense #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 6 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.

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Identifiers

StateTypeNumberIssuer
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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