MEDICARE: MR. JEFFREY P KULSA CRNP

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	163W00000X	Registered Nurse	RN512608L	PA
2	363LF0000X	Family Nurse Practitioner	SP010184	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730328303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY P KULSA CRNP

Provider Business Mailing Address
First Line	:	PO BOX 783311
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-3311
Country	:	US
Telephone Number	:	484-884-4500
Fax Number	:	484-884-0699

Provider Business Practice Location Address
First Line	:	50 MOISEY DR STE 103
Second Line	:
City	:	HAZLE TOWNSHIP
State	:	PA
Zip	:	18202-9297
Country	:	US
Telephone Number	:	570-501-6580
Fax Number	:	570-501-6598

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

Provider Enumeration Date	:	02/05/2009
Last Update Date	:	02/13/2020

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