Individual
REBECCA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1000 S MAIN ST, FLORENCE, AZ 85132-8132
(520) 723-6400
Mailing address
1000 S MAIN ST, FLORENCE, AZ 85132-8132
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP046208
AZ
Other
Enumeration date
02/01/2010
Last updated
02/01/2010
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