Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Reni Grace Pullukat

Individual provider Family Nurse Practitioner · NPI 1275994683

Mrs. Reni Grace Pullukat is a Nurse Practitioner in Lakeland, Florida. Qualified in 2015, 11 years ago. Practices with Lakeland Regional Health Systems Inc, a 503-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
11
Licensed in
FL
In the registry since
2016
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Practice location Address checks out

2815 Lakeland Hills Blvd
Lakeland, FL 33805-2224
Phone: (863) 284-5000
Fax: (863) 284-6821
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence ARNP 9203330 (FL)

Record details

NPI number1275994683
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 11, 2016
Last updated in NPPESJuly 20, 2022
Certification dateJuly 20, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Lakeland Regional Health Systems Inc — 503 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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