Individual
JENNA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
7500 MERCY ROAD, OMAHA, NE 68124-2319
(402) 398-6060
Mailing address
7500 MERCY ROAD, OMAHA, NE 68124-2319
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101259
NE
367500000X
Certified Registered Nurse Anesthetist
68437
NE
367500000X
Certified Registered Nurse Anesthetist
D137536
IA
Other
Enumeration date
07/18/2014
Last updated
10/20/2022
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