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Individual

MRS. DENISE STAGE TULGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNNP - BC

Contact information

Practice address
1710 FAWNBROOK CT, REYNOLDSBURG, OH 43068-8115
(614) 861-0469
Mailing address
1710 FAWNBROOK CT, REYNOLDSBURG, OH 43068-8115
(614) 861-0469

Taxonomy

Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
155537
OH
363LP0200X
Pediatric Nurse Practitioner
98441
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2398838
OH
Enumeration date
10/17/2009
Last updated
10/17/2009
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