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Individual
KELSI SULLIVAN
Active
Individual
KELSI SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1536
MA
363A00000X
Physician Assistant
PA16652
TX
363A00000X
Physician Assistant
Primary
PA9116863
FL
363AS0400X
Surgical Physician Assistant
1536
MA
Other
Enumeration date
01/05/2006
Last updated
12/02/2023
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