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Individual
CHERYL A. SULLIVANT
Active
Individual
CHERYL A. SULLIVANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R. N. B.S.N.
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
13-31706-102
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098080A
—
KS
01
—
100098080C
SED WAIVER
KS
Enumeration date
12/05/2006
Last updated
10/02/2008
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