Provider Demographics
NPI:1457872541
Name:KULMAN, CHRISTINA (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:KULMAN
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:BANTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGACNP-BC
Mailing Address - Street 1:1221 PINE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-3511
Mailing Address - Country:US
Mailing Address - Phone:810-987-5000
Mailing Address - Fax:810-985-2671
Practice Address - Street 1:1221 PINE GROVE AVENUE
Practice Address - Street 2:EMERGENCY MEDICINE DEPARTMENT
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-1111
Practice Address - Country:US
Practice Address - Phone:810-987-5000
Practice Address - Fax:810-985-2671
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704286184363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner