| NPI | 1245439330 |
|---|---|
| Former Name | MELISSA SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP2762) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ TAP2762) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2022-02-25 |