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Individual

LAURA SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
8316 TRAFORD LN, WEST SPRINGFIELD, VA 22152-1654
(703) 569-8400
Mailing address
2642 E SIDE DR, ALEXANDRIA, VA 22306-1707
(571) 242-9676

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024178355
VA

Other

Enumeration date
10/24/2019
Last updated
10/17/2023
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