Provider Demographics
NPI:1285064170
Name:TULI-KENDALL, ANITA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:
Last Name:TULI-KENDALL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16220 FREDERICK RD STE 418
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-4021
Mailing Address - Country:US
Mailing Address - Phone:240-503-1567
Mailing Address - Fax:240-292-1135
Practice Address - Street 1:16220 FREDERICK RD STE 418
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-4021
Practice Address - Country:US
Practice Address - Phone:240-503-1567
Practice Address - Fax:240-292-1135
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR170931363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty