Provider Demographics
NPI:1396898698
Name:TULLER, JANET MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:MARIE
Last Name:TULLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:JANET
Other - Middle Name:MARIE
Other - Last Name:STUNTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANENTE MEDICARE ENROLLMENT
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:201 N WASHINGTON ST
Practice Address - Street 2:KAISER PERMANENTE FALLS CHURCH MEDICAL CENTER
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4518
Practice Address - Country:US
Practice Address - Phone:703-237-4000
Practice Address - Fax:703-536-1395
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024102950363L00000X, 363LA2200X
VA0001102950363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
012965K92Medicare ID - Type Unspecified
Q05554Medicare UPIN