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Individual
WAMAITHA SULLIVAN
Active
Individual
WAMAITHA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
277000092
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209007740
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370647938007
—
IL
Enumeration date
09/30/2009
Last updated
06/04/2025
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