Individual
LETITIA L SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
110 LIBERTY ST, BROCKTON, MA 02301-5521
(508) 894-0400
(508) 565-0157
Mailing address
110 LIBERTY ST, BROCKTON, MA 02301-5521
(508) 894-0400
(508) 565-0157
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
116166
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0387011
—
MA
Enumeration date
02/27/2006
Last updated
07/08/2007
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