Individual
JENNIFER SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
15 GRACELAWN RD STE 203, AUBURN, ME 04210-6344
(207) 777-8959
(207) 753-3093
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8950
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP141034
ME
Other
Enumeration date
07/17/2014
Last updated
08/10/2020
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