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Individual
TIM B OSULLIVAN
Active
Individual
TIM B OSULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
154376
OH
163W00000X
Registered Nurse
Primary
RN154376
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000379377
ANTHEM
OH
05
—
2346634
—
OH
01
—
P00186819
RRMC
OH
Enumeration date
07/28/2005
Last updated
03/19/2019
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