Individual
MARYBETH SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1401 DEKALB ST, NORRISTOWN, PA 19401-3405
(484) 751-6241
Mailing address
1412 FAIRMOUNT AVE, PHILADELPHIA, PA 19130-2908
(215) 235-9600
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN507395L
PA
Other
Enumeration date
03/30/2020
Last updated
03/30/2020
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