| NPI | 1073609707 |
|---|---|
| Professional Name | ANN NICOLE SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113026) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03286) |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA3713) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CO PA3713) | |
| 363AS0400X Physician Assistant, Surgical (Licence: FL PA9113026) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-05-31 |