NPI | 1861923898 |
---|---|
Other Name | ANGELA MARIE SULLIVAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011029) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 23369) |
Enumeration Date | 2017-03-22 |
Last Update Date | 2024-10-10 |