Individual
MRS. KATHRYN ANN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1095 MARSHALL WAY, 2ND FLOOR, PLACERVILLE, CA 95667-5722
(530) 626-6155
Mailing address
PO BOX 45680, SAN FRANCISCO, CA 94145-0680
(530) 626-2919
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP265192
CA
Other
Enumeration date
02/15/2008
Last updated
02/13/2012
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