NPI | 1376219931 |
---|---|
Former Name | KATHRYN E SULLIVAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-159478) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-159478) |
Enumeration Date | 2021-08-23 |
Last Update Date | 2023-06-29 |