Provider Demographics
NPI:1275199226
Name:KUKURA, INGA BRITT (OTR/L)
Entity Type:Individual
Prefix:
First Name:INGA
Middle Name:BRITT
Last Name:KUKURA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 E GLEEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-2028
Mailing Address - Country:US
Mailing Address - Phone:732-492-0526
Mailing Address - Fax:
Practice Address - Street 1:4030 CARDINAL AT NORTH HILLS ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-2616
Practice Address - Country:US
Practice Address - Phone:984-203-7452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11547225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist