Individual
JO M SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3601 S. 6TH AVE, TUCSON, AZ 85723
(520) 629-1838
(520) 629-1773
Mailing address
3601 S. 6TH AVE, TUCSON, AZ 85723
(520) 629-1838
(520) 629-1773
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
105958
AZ
363LP2300X
Primary Care Nurse Practitioner
Primary
105958
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
864357
—
AZ
Enumeration date
07/03/2006
Last updated
02/20/2015
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