Provider Demographics
NPI:1225078850
Name:CULLEN, PATRICK J (NP)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:J
Last Name:CULLEN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9250 N 3RD ST STE 2000
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2403
Mailing Address - Country:US
Mailing Address - Phone:480-246-3000
Mailing Address - Fax:480-246-3100
Practice Address - Street 1:9250 N 3RD ST STE 2000
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2403
Practice Address - Country:US
Practice Address - Phone:480-246-3000
Practice Address - Fax:480-246-3100
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-04387363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2578992Medicaid