Individual
MICHAEL M O'SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
10 LINCOLN ST, SPRINGFIELD, VT 05156-2510
(802) 885-7280
(802) 885-2593
Mailing address
1 HOSPITAL CT, STE 410, BELLOWS FALLS, VT 05101-1489
(802) 463-3294
(802) 463-1206
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0260021218
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39945
BLUE CROSS
VT
Enumeration date
03/27/2007
Last updated
07/08/2007
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