Provider Demographics
NPI:1588096267
Name:CULLEN-LUTTER, KATHLEEN (RN/NM)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:CULLEN-LUTTER
Suffix:
Gender:F
Credentials:RN/NM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 RESEARCH PL
Mailing Address - Street 2:SUITE 320
Mailing Address - City:N CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2454
Mailing Address - Country:US
Mailing Address - Phone:978-256-1858
Mailing Address - Fax:978-788-7890
Practice Address - Street 1:20 RESEARCH PL
Practice Address - Street 2:SUITE320
Practice Address - City:N CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2454
Practice Address - Country:US
Practice Address - Phone:978-256-1858
Practice Address - Fax:978-788-7890
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN214968367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife