Individual
JESSIE MAE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
5353 N UNION BLVD STE 201-D, COLORADO SPRINGS, CO 80918-2065
(720) 515-2181
Mailing address
5353 N UNION BLVD STE 201-D, COLORADO SPRINGS, CO 80918-2065
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
04/24/2012
Last updated
03/17/2018
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