Provider Demographics
NPI:1619939840
Name:CULLEN, JANE C (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:C
Last Name:CULLEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:JANE
Other - Middle Name:CRISWELL
Other - Last Name:CULLEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:7928 SW 17TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-3444
Mailing Address - Country:US
Mailing Address - Phone:352-331-8125
Mailing Address - Fax:
Practice Address - Street 1:SHCC UNIVERSITY OF FLORIDA CAMPUS
Practice Address - Street 2:1 FLETCHER DRIVE
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-7500
Practice Address - Country:US
Practice Address - Phone:352-392-1161
Practice Address - Fax:352-392-9625
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 578432363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily