Provider Demographics
NPI:1487737581
Name:CULLINAN, SHARON ANNE (FNP)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANNE
Last Name:CULLINAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7904 HAYMARKIT LANE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615
Mailing Address - Country:US
Mailing Address - Phone:919-846-2795
Mailing Address - Fax:
Practice Address - Street 1:1001 ROCK QUARRRY ROAD
Practice Address - Street 2:ROCK QUARRY ROAD FAMILY MEDICINE
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610
Practice Address - Country:US
Practice Address - Phone:919-833-3111
Practice Address - Fax:919-832-3112
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200841363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P29110Medicare UPIN