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Individual

TAMMY LYNNE SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-1743
Mailing address
3918 WOODHURST DR, TOLEDO, OH 43614-3309
(419) 350-8285

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN214205
OH

Other

Enumeration date
03/01/2019
Last updated
03/01/2019
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