Provider Demographics
NPI:1518582477
Name:HULTGREN, PATRICIA (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:HULTGREN
Suffix:
Gender:
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 W FLINTLOCK WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-6478
Mailing Address - Country:US
Mailing Address - Phone:402-208-1535
Mailing Address - Fax:
Practice Address - Street 1:16611 S 40TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0563
Practice Address - Country:US
Practice Address - Phone:480-610-6366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-16
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ242513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily