Individual
LESLIE JEANETTE COOPER SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
426 N 44TH ST STE 405, PHOENIX, AZ 85008-6612
(602) 476-2047
Mailing address
10646 E CAROL AVE, MESA, AZ 85208-7434
(480) 450-5999
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RNP318160
AZ
Other
Enumeration date
01/10/2025
Last updated
02/25/2025
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