Individual
JILLIAN CULLINANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4800 BELFORT RD, JACKSONVILLE, FL 32256-6004
(904) 483-5850
(904) 483-5860
Mailing address
PO BOX 100111, COLUMBIA, SC 29202-3111
(845) 596-6394
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR14781900
NJ
163W00000X
Registered Nurse
532232-1
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11014964
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111966800
—
FL
Enumeration date
11/19/2012
Last updated
11/22/2021
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