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1407694789
KELLY SULLIVAN
PORT SAINT LUCIE, FL
NPI
1407694789
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: FL 11034152)
Enumeration Date
2024-07-19
Last Update Date
2024-07-19
Business Address
Mrs. KELLY SULLIVAN APRN
10198 SW VILLAGE PKWY STE 105
PORT SAINT LUCIE, FL 34987-2592
Phone number: 772-934-4990
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Mailing Address
Mrs. KELLY SULLIVAN APRN
2598 SW DANIA ST
PORT SAINT LUCIE, FL 34953-7307
Phone number: 561-345-5343
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