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1124455704
LAURA NASTASSJA SULLIVAN
APEX, NC
NPI
1124455704
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 0010-04483)
Enumeration Date
2013-09-27
Last Update Date
2022-06-01
Business Address
LAURA NASTASSJA SULLIVAN PA
1011 PEMBERTON HILL RD STE 101
APEX, NC 27502-4266
Phone number: 919-620-4700
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Mailing Address
LAURA NASTASSJA SULLIVAN PA
PO BOX 751274
CHARLOTTE, NC 28275-1274
Phone number: 919-620-4700
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