Individual
KELLY S SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
21 GRAND ST, HARTFORD, CT 06106-1541
(860) 550-7500
Mailing address
42 PEARL ST, HOLYOKE, MA 01040-2657
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6133
CT
363LF0000X
Family Nurse Practitioner
RN276589
MA
Other
Enumeration date
11/05/2017
Last updated
11/05/2017
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