Provider Demographics
NPI:1770077984
Name:KULIK, JENNIFER ANN (RNFA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANN
Last Name:KULIK
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:ANN
Other - Last Name:RANDAZZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:19885 GOLDEN BRIDGE TRAIL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498
Mailing Address - Country:US
Mailing Address - Phone:407-702-5798
Mailing Address - Fax:877-900-5188
Practice Address - Street 1:19885 GOLDEN BRIDGE TRAIL
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498
Practice Address - Country:US
Practice Address - Phone:407-702-5798
Practice Address - Fax:877-900-5188
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9251030163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant