Individual
MRS. MICHELLE B SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3292 COUNTY ROAD 220, MIDDLEBURG, FL 32068-4357
(904) 291-5561
Mailing address
3292 COUNTY ROAD 220, MIDDLEBURG, FL 32068-4357
(904) 291-5561
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
ARNP3144812
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN3144812
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ARNP3144812
FL LICENSE
FL
Enumeration date
09/12/2016
Last updated
07/20/2021
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