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Individual

KRISTINA L SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
800 GARFIELD AVE, PARKERSBURG, WV 26101-5340
(304) 424-2590
(304) 422-3924
Mailing address
601 AVERY ST STE 501, PARKERSBURG, WV 26101-5192
(304) 422-3904
(304) 422-3924

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
45817
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2441281
OH
05
2605395000
WV
Enumeration date
10/06/2005
Last updated
08/24/2022
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