| NPI | 1982142519 |
|---|---|
| Other Name | JESSICA JEANNE SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2306549) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2306549) |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2021-06-10 |