| NPI | 1770144776 |
|---|---|
| Former Name | CAITLIN MICHELLE SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704317140) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704317140) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2025-06-10 |