Provider Demographics
NPI:1104237684
Name:ABI, KULLING NJI
Entity type:Individual
Prefix:
First Name:KULLING
Middle Name:NJI
Last Name:ABI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 SIMON LN APT 103
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-1742
Mailing Address - Country:US
Mailing Address - Phone:330-990-8071
Mailing Address - Fax:
Practice Address - Street 1:901 SIMON LN APT 103
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-1742
Practice Address - Country:US
Practice Address - Phone:330-990-8071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-18
Last Update Date:2021-12-15
Deactivation Date:2021-11-29
Deactivation Code:
Reactivation Date:2021-12-14
Provider Licenses
StateLicense IDTaxonomies
OHPN134199M-IV164W00000X
OHAPRN.CNP.0029881363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse