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1477158905
ALICIA KIM SULLIVAN
EDWARDSVILLE, IL
NPI
1477158905
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 2093022275)
Enumeration Date
2020-12-02
Last Update Date
2020-12-02
Business Address
ALICIA KIM SULLIVAN NP
441 S STATE ROUTE 157 STE 102
EDWARDSVILLE, IL 62025-4017
Phone number: 618-254-2273
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Mailing Address
ALICIA KIM SULLIVAN NP
441 S STATE ROUTE 157 STE 102
EDWARDSVILLE, IL 62025-4017
Phone number: 618-254-2273
Copy
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