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NPI Code Detail

MEDICARE: MARY GRACE CULLEN NP

MEDICARE:   MARY GRACE CULLEN  NP
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
1363LF0000XFamily Nurse PractitionerAPRN11040052FL

General Provider Information

NPI Number : 1740171800
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY GRACE CULLEN NP
Provider Business Mailing Address
First Line : 1711 W NORTH B ST
Second Line :
City : TAMPA
State : FL
Zip : 33606-1635
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7550 N DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33614-3226
Country : US
Telephone Number : 813-885-4706
Fax Number : 813-885-9463
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2025
Last Update Date : 06/02/2026

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Directions to “ MARY GRACE CULLEN NP” Practice Location

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