NPI | 1821499336 |
---|---|
Former Name | CHRISTY LYNN SULLIVAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: OK R0112502) |
Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: MO 2018009258) |
363LN0000X Nurse Practitioner, Neonatal (Licence: AR R66633) | |
Enumeration Date | 2014-09-16 |
Last Update Date | 2018-04-05 |