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Individual
REBECCA JEANNE SULLIVAN
Active
Individual
REBECCA JEANNE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
691809
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
AP123430
TX
Other
Enumeration date
04/26/2013
Last updated
04/13/2021
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