Individual
KATHERYN ANN SULLLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
214 E AVENUE B, BISMARCK, ND 58501-3649
(701) 202-4978
Mailing address
214 E AVENUE B, BISMARCK, ND 58501-3649
(701) 202-4978
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3747P1801X
—
ND
Enumeration date
02/08/2022
Last updated
02/08/2022
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