Basic Information
| Provider Information | |||||||||
| NPI: | 1184736969 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KULAS | ||||||||
| FirstName: | DONNA | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | R.N.C. , M.S., N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 526 MAIN ST 302 | ||||||||
| Address2: | |||||||||
| City: | ACTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017203301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783717010 | ||||||||
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| Practice Location | |||||||||
| Address1: | 54 BAKER AVENUE EXT 305 | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017422143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783717010 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 10/28/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 212537 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | NP3898 | 01 | MA | BC/BS | OTHER | 98109 | 01 | MA | FALLEN COMMUNITY HEALTH C | OTHER |