Healthcare Provider Details

I. General information

NPI: 1710871983
Provider Name (Legal Business Name): CONCETTA LULLA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 HOMESTEAD AVE
WHEELING WV
26003-6638
US

IV. Provider business mailing address

406 WILSHIRE BLVD
STEUBENVILLE OH
43952-1168
US

V. Phone/Fax

Practice location:
  • Phone: 304-232-1020
  • Fax: 304-232-1209
Mailing address:
  • Phone: 740-632-5019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number123881
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0039396
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: