Provider Demographics
NPI:1982386835
Name:KULP, ALEXIS (RDN)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:KULP
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 ROMIG RD
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-9730
Mailing Address - Country:US
Mailing Address - Phone:609-781-3796
Mailing Address - Fax:
Practice Address - Street 1:638 NEWTOWN YARDLEY RD STE 2G
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1740
Practice Address - Country:US
Practice Address - Phone:267-443-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN007676133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered