Provider Demographics
NPI:1184421356
Name:KULLBERG, HANNAH (PA-C)
Entity type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:
Last Name:KULLBERG
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 TADMUCK LN
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-2017
Mailing Address - Country:US
Mailing Address - Phone:978-320-1994
Mailing Address - Fax:
Practice Address - Street 1:12 TADMUCK LN
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-2017
Practice Address - Country:US
Practice Address - Phone:978-320-1994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant