Provider Demographics
NPI:1932927563
Name:KRULISH, WENDY KAY (RN)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:KAY
Last Name:KRULISH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 E CONNELL ST
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1321
Mailing Address - Country:US
Mailing Address - Phone:585-307-4594
Mailing Address - Fax:
Practice Address - Street 1:921 N UNION ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1429
Practice Address - Country:US
Practice Address - Phone:585-307-4594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY485437163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse