Provider Demographics
NPI:1083918841
Name:KULENIC, KATHERINE MCDANIEL (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MCDANIEL
Last Name:KULENIC
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3612 SHANNON RD
Mailing Address - Street 2:SUITE # 105
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707
Mailing Address - Country:US
Mailing Address - Phone:919-419-0242
Mailing Address - Fax:919-401-4172
Practice Address - Street 1:3612 SHANNON RD
Practice Address - Street 2:SUITE # 105
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6329
Practice Address - Country:US
Practice Address - Phone:919-419-0242
Practice Address - Fax:919-401-4172
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily