Provider Demographics
NPI:1245682889
Name:KULWICKI, KARINNE (PA)
Entity type:Individual
Prefix:
First Name:KARINNE
Middle Name:
Last Name:KULWICKI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 488
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:NE
Mailing Address - Zip Code:69022-0488
Mailing Address - Country:US
Mailing Address - Phone:308-697-3317
Mailing Address - Fax:308-697-4918
Practice Address - Street 1:1305 HIGHWAY 6 34
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:NE
Practice Address - Zip Code:69022-6616
Practice Address - Country:US
Practice Address - Phone:308-697-3317
Practice Address - Fax:308-697-4918
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE2040363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant