Individual
STEPHANIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
705 GATE LN STE 202, KNOXVILLE, TN 37909-3521
(865) 309-4655
(844) 464-0899
Mailing address
103 GRAGG ST, BLACK MOUNTAIN, NC 28711-9202
(610) 413-3713
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L006467
NC
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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