# JOAN MARIE SULLIVAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1043393150
- **Gender:** F
- **Credential:** PAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 5601003370 | MI | Yes |
| 363AS0400X | Surgical Physician Assistant | 1046093 | OK | — |

## Other

- **Enumeration date:** 10/23/2006
- **Last updated:** 01/12/2026