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NPI Code Detail

MEDICARE: ELIZABETH A CULLEN N.P.

MEDICARE: ELIZABETH A CULLEN N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner104651CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679556203
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH A CULLEN N.P.
Provider Business Mailing Address
First Line : 1333 IRIS AVE
Second Line :
City : BOULDER
State : CO
Zip : 80304-2226
Country : US
Telephone Number : 303-443-8500
Fax Number :
Provider Business Practice Location Address
First Line : 1333 IRIS AVE
Second Line :
City : BOULDER
State : CO
Zip : 80304-2226
Country : US
Telephone Number : 303-443-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 11/30/2016

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