Provider Demographics
NPI:1073059796
Name:KULLIK, BARBARA (RN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:KULLIK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 OMRE AVENUE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725
Mailing Address - Country:US
Mailing Address - Phone:740-630-3164
Mailing Address - Fax:
Practice Address - Street 1:515 ORME AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-9489
Practice Address - Country:US
Practice Address - Phone:740-630-3164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.406705163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse