Provider Demographics
NPI:1679960629
Name:CIRULLI, KELLIE (RN-BC)
Entity Type:Individual
Prefix:MS
First Name:KELLIE
Middle Name:
Last Name:CIRULLI
Suffix:
Gender:F
Credentials:RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 CAPRI LN
Mailing Address - Street 2:
Mailing Address - City:BLANDON
Mailing Address - State:PA
Mailing Address - Zip Code:19510-9483
Mailing Address - Country:US
Mailing Address - Phone:610-401-8179
Mailing Address - Fax:
Practice Address - Street 1:210 CAPRI LN
Practice Address - Street 2:
Practice Address - City:BLANDON
Practice Address - State:PA
Practice Address - Zip Code:19510-9483
Practice Address - Country:US
Practice Address - Phone:610-401-8179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN330234L163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health