| NPI | 1205166121 |
|---|---|
| Former Name | RACHAEL ELIZABETH SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP010606) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010606) |
| Enumeration Date | 2009-12-29 |
| Last Update Date | 2017-03-29 |