Healthcare Provider Details

I. General information

NPI: 1225941826
Provider Name (Legal Business Name): KULA KIADII
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 KAREN BLVD
DISTRICT HEIGHTS MD
20747-1757
US

IV. Provider business mailing address

7600 GEORGIA AVE NW STE 308
WASHINGTON DC
20012-1616
US

V. Phone/Fax

Practice location:
  • Phone: 202-800-9005
  • Fax:
Mailing address:
  • Phone: 202-800-9005
  • Fax: 202-248-2044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN1004626
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: