Provider Demographics
NPI:1376823864
Name:CULLEN, JO ANN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JO
Middle Name:ANN
Last Name:CULLEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 PEBBLEBROOK CT
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-1935
Mailing Address - Country:US
Mailing Address - Phone:813-334-9996
Mailing Address - Fax:
Practice Address - Street 1:7 MALLETT WAY
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-6064
Practice Address - Country:US
Practice Address - Phone:843-815-6699
Practice Address - Fax:843-815-6695
Is Sole Proprietor?:No
Enumeration Date:2011-08-28
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9186216363LF0000X
SC20192363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner