Individual
DR. TIYIKA JANAYE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4692 BROWNSBORO RD, WINSTON SALEM, NC 27106-3410
(336) 251-1114
(336) 251-1115
Mailing address
4692 BROWNSBORO RD, WINSTON SALEM, NC 27106-0000
(336) 251-1114
(336) 251-1115
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5007480
NC
Other
Enumeration date
02/17/2015
Last updated
10/13/2021
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