Individual
SHAMECKA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1000 NEIGHBORHOOD PL, FAIRDALE, KY 40118-9697
(502) 361-2381
(502) 996-8309
Mailing address
PO BOX 392552, PITTSBURGH, PA 15251-9500
(512) 792-4402
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4024554
KY
Other
Enumeration date
08/20/2024
Last updated
03/07/2025
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