Provider Demographics
NPI:1356374227
Name:HULL, PATSY L (CRNA)
Entity type:Individual
Prefix:MS
First Name:PATSY
Middle Name:L
Last Name:HULL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 S OSPREY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2905
Mailing Address - Country:US
Mailing Address - Phone:913-558-3557
Mailing Address - Fax:866-665-2702
Practice Address - Street 1:1435 S OSPREY AVE STE 100
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2905
Practice Address - Country:US
Practice Address - Phone:913-558-3557
Practice Address - Fax:866-665-2702
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1341961111163W00000X
KS54622367500000X
MO077411367500000X
FLARNP2875412367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100249680CMedicaid