Individual
KATHLEEN RUTH SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.M.
Contact information
Practice address
75 FRANCIS ST, CONNORS CENTER 405, BOSTON, MA 02115-6110
(617) 732-5053
(617) 975-0987
Mailing address
11 EDDY ST, NEWTON, MA 02465-2132
(617) 527-5195
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
135819
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002550
NEIGHBORHOOD HEALTH PLAN
MA
Enumeration date
10/23/2006
Last updated
03/01/2013
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