Individual
ARLENE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
9500 KANIS RD, HICKINGBOTHAM OUTPATIENT CENTER, LITTLE ROCK, AR 72205-6324
(501) 202-1902
(501) 202-1512
Mailing address
11001 EXECUTIVE CENTER DR, SUITE 200, LITTLE ROCK, AR 72211-4316
(501) 202-1902
(501) 202-1512
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
A01250
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5U030
BCBS
—
01
—
71-0781138
MERCY
—
01
—
71-0781138028
TRICARE
—
01
—
742252
HEALTHLINK
—
01
—
7525325
CIGNA
—
Enumeration date
07/27/2006
Last updated
05/20/2008
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