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1154590651
KELLY SULLIVAN
BRIDGEPORT, CT
NPI
1154590651
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: CT 002446)
Enumeration Date
2008-02-28
Last Update Date
2008-02-28
Business Address
KELLY SULLIVAN
275 GEORGE ST
BRIDGEPORT, CT 06604-3320
Phone number: 203-576-8462
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Mailing Address
KELLY SULLIVAN
6 FOX RUN
WILTON, CT 06897-1110
Phone number: 203-576-8461
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