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Individual

LAUREN T SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2400 WITZEL AVE STE A, OSHKOSH, WI 54904-8375
(920) 233-1540
(920) 651-6951
Mailing address
2400 WITZEL AVE STE A, OSHKOSH, WI 54904-8375
(920) 233-1540
(920) 651-6951

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
154169
WI
363L00000X
Nurse Practitioner
Primary
4955-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100025102
WI
01
2012010636
ANCC
WI
Enumeration date
07/31/2012
Last updated
07/11/2024
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