Individual
AMY IRIS SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
939 ROUTE 146 STE 620, CLIFTON PARK, NY 12065-3629
(518) 925-7217
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404245
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/26/2022
Last updated
01/21/2025
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