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NPI Code Detail

MEDICARE: ALEXANDRA ANNE KULICK

MEDICARE: ALEXANDRA ANNE KULICK
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
1367A00000XAdvanced Practice Midwife236629CA

General Provider Information

NPI Number : 1740113224
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA ANNE KULICK
Provider Business Mailing Address
First Line : 1077 EMERALD ST APT B
Second Line :
City : SAN DIEGO
State : CA
Zip : 92109-2821
Country : US
Telephone Number : 734-545-3348
Fax Number :
Provider Business Practice Location Address
First Line : 2500 NE NEFF RD
Second Line :
City : BEND
State : OR
Zip : 97701-6015
Country : US
Telephone Number : 734-545-3348
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/04/2026

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Directions to “ ALEXANDRA ANNE KULICK ” Practice Location

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