Provider Demographics
NPI:1649755406
Name:CULLEN, ASHLEE (RN)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:CULLEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 ALABAMA ST APT E
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-3546
Mailing Address - Country:US
Mailing Address - Phone:714-913-5226
Mailing Address - Fax:
Practice Address - Street 1:1565 ADAMS AVE STE 138
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-3814
Practice Address - Country:US
Practice Address - Phone:714-913-5226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty