| NPI | 1982706180 |
|---|---|
| Other Name | DEDE SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NH 056917-23) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 056917-23) |
| 363L00000X Nurse Practitioner (Licence: MA 255102) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2022-04-05 |