Provider Demographics
NPI:1235858937
Name:PATULLO, MORGAN NICOLE (DNP, AGACNP-BC)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:NICOLE
Last Name:PATULLO
Suffix:
Gender:F
Credentials:DNP, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 LITTLE ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1914
Mailing Address - Country:US
Mailing Address - Phone:732-235-2465
Mailing Address - Fax:
Practice Address - Street 1:195 LITTLE ALBANY ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1914
Practice Address - Country:US
Practice Address - Phone:732-235-2465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR228112163WX0200X
NJ26NJ01361500363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WX0200XNursing Service ProvidersRegistered NurseOncology