Provider Demographics
NPI:1619581584
Name:HULSEY, LUANA IRENE
Entity Type:Individual
Prefix:
First Name:LUANA
Middle Name:IRENE
Last Name:HULSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2144 WICKLOW PL
Mailing Address - Street 2:
Mailing Address - City:POINT ROBERTS
Mailing Address - State:WA
Mailing Address - Zip Code:98281-9517
Mailing Address - Country:US
Mailing Address - Phone:972-880-9091
Mailing Address - Fax:
Practice Address - Street 1:3408 BOXWOOD AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-8400
Practice Address - Country:US
Practice Address - Phone:972-880-9091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider