Healthcare Provider Details

I. General information

NPI: 1811427164
Provider Name (Legal Business Name): JEAN KULAS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CORPORATE DR STE 394
SHELTON CT
06484-6240
US

IV. Provider business mailing address

4 CORPORATE DR STE 394
SHELTON CT
06484-6240
US

V. Phone/Fax

Practice location:
  • Phone: 203-255-0375
  • Fax: 203-225-0376
Mailing address:
  • Phone: 203-225-0375
  • Fax: 203-225-0376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7047
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: