Individual
ANGELA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
500 S UNIVERSITY AVE STE 505, LITTLE ROCK, AR 72205-5307
(501) 664-4532
(501) 663-4335
Mailing address
500 S UNIVERSITY AVE STE 505, LITTLE ROCK, AR 72205-5307
(501) 664-4532
(501) 663-4335
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
L036409
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
C003030
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208379001
—
AR
Enumeration date
06/04/2014
Last updated
01/25/2017
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