MEDICARE: STEFANIE KULLMANN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	L548011	MI

General Provider Information

NPI Number	:	1073965935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFANIE KULLMANN

Provider Business Mailing Address
First Line	:	1900 S. LIVERNOIS
Second Line	:	INSIDE RED LOTUS YOGA
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307
Country	:	US
Telephone Number	:	313-355-0871
Fax Number	:	--

Provider Business Practice Location Address
First Line	:	1900 S. LIVERNOIS RD
Second Line	:	INSIDE RED LOTUS YOGA
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307
Country	:	US
Telephone Number	:	313-355-0871
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2016
Last Update Date	:	01/11/2026

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