Provider Demographics
NPI:1306579669
Name:TULLIUS, ABIGAIL ABERILLA (NP)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:ABERILLA
Last Name:TULLIUS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SUZANNE LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-9514
Mailing Address - Country:US
Mailing Address - Phone:360-720-6682
Mailing Address - Fax:
Practice Address - Street 1:201 SUZANNE LN
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-9514
Practice Address - Country:US
Practice Address - Phone:360-416-1960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61327423363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner