Healthcare Provider Details

I. General information

NPI: 1053575654
Provider Name (Legal Business Name): JULIE D CULMONE APRN-BC, CWOCN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE A DESHAIES RN, APRN

II. Dates (important events)

Enumeration Date: 07/12/2008
Last Update Date: 02/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 WOODLAND ST DEPT OF SURGERY
HARTFORD CT
06105-1208
US

IV. Provider business mailing address

121 SHUNPIKE RD
CROMWELL CT
06416-1178
US

V. Phone/Fax

Practice location:
  • Phone: 860-714-5942
  • Fax:
Mailing address:
  • Phone: 860-635-7921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License Number066597
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number066597
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number3812
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: