Healthcare Provider Details

I. General information

NPI: 1083936322
Provider Name (Legal Business Name): PAUL M. KULP APRN/PMH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2010
Last Update Date: 01/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 OLD GEORGETOWN RD
BETHESDA MD
20814-1422
US

IV. Provider business mailing address

8600 OLD GEORGETOWN RD
BETHESDA MD
20814-1422
US

V. Phone/Fax

Practice location:
  • Phone: 240-242-7769
  • Fax:
Mailing address:
  • Phone: 301-896-2218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberR118086
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: