Michelle Marie Krutulis, RN

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

RN240445L Issued in PA

Practice address

851 Commerce Blvd Ste 107
Dickson City, PA 18519-1762

Phone

(570) 489-5561

Fax

(570) 489-5563

NPI assigned

Nov 13, 2018

Sex

Female

Sole proprietor

No

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1538637152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 COMMERCE BLVD STE 107",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "185191762",
            "telephone_number": "570-489-5561",
            "fax_number": "570-489-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 COMMERCE BLVD STE 107",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "185191762",
            "telephone_number": "570-489-5561",
            "fax_number": "570-489-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUTULIS",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "PA",
            "license": "RN240445L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Dickson City, PA
• Providers in Dickson City, PA by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.