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General NPI Number Information
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NPI Number | 1285519603
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Entity Type | Organization
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Legal Business Name | VENUS COLLECTIVE WOMEN'S HEALTH AND INTIMACY
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 22 NORTH DR
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City | STURBRIDGE
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State | MA
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Zip | 01518-1161
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Country | US
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Telephone | 812-236-7743
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Fax |
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Provider Business Mailing Address
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Address Line | 22 NORTH DR
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City | STURBRIDGE
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State | MA
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Zip | 01518-1161
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Country | US
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Telephone | 812-236-7743
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Fax |
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Authorized Official
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Title or Position | OWNER, PROVIDER
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Name | KELLY TULL
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Credential | WHNP
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Telephone | 812-236-7743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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