Individual
MISS KELLY LUCILLE TULP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
101 MANNING DR, CHAPEL HILL, NC 27514-4226
(919) 966-4643
Mailing address
101 MANNING DR, CHAPEL HILL, NC 27514-4226
(919) 966-4643
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
001010811
NC
363AS0400X
Surgical Physician Assistant
PA107723
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016594100
—
FL
Enumeration date
03/05/2014
Last updated
06/30/2022
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