Kathleen Anne Nulty, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

23459701 Issued in NY

Practice address

29 S Prospect Ave
Patchogue, NY 11772-3209

Phone

(631) 879-7614

NPI assigned

Dec 10, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1225211527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 S PROSPECT AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723209",
            "telephone_number": "631-879-7614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 S PROSPECT AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723209",
            "telephone_number": "631-879-7614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NULTY",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "23459701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Patchogue Fire District
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• Jillian Nostro, DO
• John N Noveck, PA
• Ny Jamesport Acupuncture, PC
• Ny Spine Physical Therapy
• Nyc Orthopedic and Spine, P.C.
• NYU Langone Hospitals
• NYU Langone Hospitals

• Licensed Practical Nurse in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.