Provider Demographics
NPI:1427390301
Name:TULYSSE, MILDRINE (DNP, MSN, CNP,FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MILDRINE
Middle Name:
Last Name:TULYSSE
Suffix:
Gender:F
Credentials:DNP, MSN, CNP,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 COMMONWEALTH AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-5193
Mailing Address - Country:US
Mailing Address - Phone:781-897-8400
Mailing Address - Fax:
Practice Address - Street 1:15 COMMONWEALTH AVE FL 3
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-5193
Practice Address - Country:US
Practice Address - Phone:781-897-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN273105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily