Kelly Tull, WHNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

RN2323729 Issued in MA

Practice address

22 North Dr
Fiskdale, MA 01518-1161

Phone

(812) 236-7743

NPI assigned

Oct 25, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 25, 2026 through May 25, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Venus Collective Women'S Health and Intimacy

  • Women's Health Nurse Practitioner
  • East Longmeadow, MA
  • NPI 1285519603

  Women'S Health

  NPD Authorized official
• Center for Pelvic Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • West Springfield, MA
  • NPI 1043607351
  NPD (past)
• Connecticut OB-GYN,LLC

  • Obstetrics & Gynecology Physician
  • East Hartford, CT
  • NPI 1316001324
  NPD (past)
• Open Door Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hartford City, IN
  • NPI 1245094028
  NPD (past)

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1306398409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 NORTH DR",
            "city": "FISKDALE",
            "state": "MA",
            "postal_code": "015181161",
            "telephone_number": "812-236-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 NORTH DR",
            "city": "FISKDALE",
            "state": "MA",
            "postal_code": "015181161",
            "telephone_number": "812-236-7743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULL",
        "first_name": "KELLY",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CT",
            "license": "7658",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IN",
            "license": "28185781A",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "RN2323729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Town of Brimfield
• Town of Brookfield
• Town of Holland
• Town of Wales
• Treasurer Town of Sturbridge
• Bailey Elizabeth Vanderwarker
• Joyce Elizabeth Wickman, M.A.

• All providers in Fiskdale, MA
• Women's Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.