Provider Demographics
NPI:1629023536
Name:KULIKOWSKI, BRENDA I (MSN; CERTIFIED NURSE)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:I
Last Name:KULIKOWSKI
Suffix:
Gender:F
Credentials:MSN; CERTIFIED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:982 EAST MAIN STREET
Mailing Address - Street 2:OPTIMUS HEALTH CARE
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06608
Mailing Address - Country:US
Mailing Address - Phone:203-696-3260
Mailing Address - Fax:203-696-3250
Practice Address - Street 1:982 EAST MAIN STREET
Practice Address - Street 2:OPTIMUS HEALTH CARE
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06608
Practice Address - Country:US
Practice Address - Phone:203-696-3260
Practice Address - Fax:203-696-3250
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000003367A00000X
176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000003OtherSTATE LICENSE