Individual
MRS. DEBORAH LEE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
211 E LOGAN ST, SUITE 105, CALDWELL, ID 83605-4882
(208) 454-0567
(208) 402-6635
Mailing address
3706 N STONE CREEK WAY, BOISE, ID 83703-4745
(208) 514-3217
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
NP891
ID
Other
Enumeration date
12/15/2008
Last updated
03/26/2019
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