Provider Demographics
NPI:1770239907
Name:KEHINDE KULUGH NP LLC
Entity Type:Organization
Organization Name:KEHINDE KULUGH NP LLC
Other - Org Name:KEHINDE KULUGH NP LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KEHINDE
Authorized Official - Middle Name:
Authorized Official - Last Name:KULUGH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:718-207-0266
Mailing Address - Street 1:7023 MORNING STAR DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-7241
Mailing Address - Country:US
Mailing Address - Phone:718-207-0266
Mailing Address - Fax:
Practice Address - Street 1:7023 MORNING STAR DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75054-7241
Practice Address - Country:US
Practice Address - Phone:718-207-0266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service