Provider Demographics
NPI:1073846044
Name:KULPA, CARL GEORGE (MS, ANP-BC, ACNP-BC)
Entity type:Individual
Prefix:MR
First Name:CARL
Middle Name:GEORGE
Last Name:KULPA
Suffix:
Gender:M
Credentials:MS, ANP-BC, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:M/C 5221
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-736-2537
Mailing Address - Fax:650-736-2547
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:M/C 5221
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-736-2537
Practice Address - Fax:650-736-2547
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21255363LA2100X, 363LA2200X
OHAPRN.CNP.11095363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3101548Medicaid
OHKUNP38331Medicare PIN