Individual
MRS. ERIN CLEARY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2003015404
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
182433
BCBS
MO
01
—
629885
HEALTHLINK
MO
Enumeration date
10/14/2005
Last updated
01/16/2008
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