Active NPI
Shannon H Cullan, NP
- Nurse Practitioner
- Lincoln, NE
National Provider Identifier
1992922058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 111105
- Practice address
- 4121 Thorn CT
Lincoln, NE 68520-9322 - Phone
- (402) 419-9885
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 111105 | NE | Primary |
Addresses
Primary practice location
4121 Thorn CT
Lincoln, NE 68520-9322
Mailing address
4121 Thorn CT
Lincoln, NE 68520-9322
Phone (402) 419-9885
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP17174 | Other | CA | NP LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616025600000",
"number": "1992922058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4121 THORN CT",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685209322",
"telephone_number": "402-419-9885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4121 THORN CT",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685209322",
"telephone_number": "402-419-9885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULLAN",
"first_name": "SHANNON",
"middle_name": "H",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2021-03-18",
"certification_date": "2021-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NE",
"license": "111105",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NP LICENSE",
"identifier": "NP17174",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.