Individual
AMANDA ROSE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
86 BAKER AVE EXTENSION, SUITE 100, CONCORD, MA 01742
(978) 369-1113
Mailing address
86 BAKER AVE EXTENSION, SUITE 100, CONCORD, MA 01742
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2262691
MA
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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