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General NPI Number Information
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NPI Number | 1225542970
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Entity Type | Individual
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Provider Name | MIKAYLA E CULPO MSN, CPNP
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Gender | Female
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 9 HOPE AVE FL BCH4
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City | WALTHAM
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State | MA
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Zip | 02453
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Country | US
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Telephone | 781-216-1960
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Fax | 781-216-2540
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Provider Business Mailing Address
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Address Line | 333 LONGWOOD AVE
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City | BOSTON
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State | MA
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Zip | 02115-5711
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Country | US
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Telephone | 781-216-1650
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN2282224
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License Number State | MA
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