Individual
MRS. ANNATA RAE SULLIVAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN, APRN
Contact information
Practice address
697 LOUISIANA DR., DYESS, AFB, TX 79607-4425
(325) 696-3543
Mailing address
2917 STONECREST DR, ABILENE, TX 79606-3453
(325) 691-5232
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
110470
NE
Other
Enumeration date
03/07/2006
Last updated
07/08/2007
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