| NPI | 1962807917 |
|---|---|
| Former Name | ELIZABETH MARIE SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OR 201501606NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60551124) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 19334) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: WA AP60551124) | |
| Enumeration Date | 2014-11-01 |
| Last Update Date | 2018-03-17 |