Individual provider Active NPI

Mildrine Tulysse, DNP, MSN, CNP,FNP-BC

  • Family Nurse Practitioner
  • Woburn, MA
National Provider Identifier
1427390301
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN273105 Issued in MA
Practice address
15 Commonwealth Ave FL 3
Woburn, MA 01801-5193
Phone
(781) 897-8400
NPI assigned
Mar 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN273105 MA Primary

Addresses

Primary practice location

15 Commonwealth Ave FL 3
Woburn, MA 01801-5193

Mailing address

15 Commonwealth Ave FL 3
Woburn, MA 01801-5193
Phone (781) 897-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN273105MAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1427390301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 COMMONWEALTH AVE FL 3",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018015193",
            "telephone_number": "781-897-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 COMMONWEALTH AVE FL 3",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018015193",
            "telephone_number": "781-897-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULYSSE",
        "first_name": "MILDRINE",
        "name_prefix": "Ms.",
        "credential": "DNP, MSN, CNP,FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-19",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN273105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.