Individual
JANE SULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1845 MIDCHESTER DR, WEST BLOOMFIELD, MI 48324-1138
(248) 722-4644
Mailing address
1845 MIDCHESTER DR, WEST BLOOMFIELD, MI 48324-1138
(248) 722-4644
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704270879
MI
Other
Enumeration date
06/08/2009
Last updated
03/18/2015
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