Healthcare Provider Details

I. General information

NPI: 1831006071
Provider Name (Legal Business Name): COLIN CULLITAN APN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 S LEMAY AVE STE 100
FORT COLLINS CO
80524-3956
US

IV. Provider business mailing address

1107 S LEMAY AVE STE 100
FORT COLLINS CO
80524-3956
US

V. Phone/Fax

Practice location:
  • Phone: 970-207-4857
  • Fax:
Mailing address:
  • Phone: 970-207-4857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: