Individual
TERRI JEAN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19715 WAR ADMIRAL RD, EAGLE RIVER, AK 99577-8473
(907) 726-0662
Mailing address
19715 WAR ADMIRAL RD, EAGLE RIVER, AK 99577-8473
(907) 726-0662
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
35531
AK
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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