Individual
MIKLYNN RAEANNE PEARL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
425 JULIANA ST, PARKERSBURG, WV 26101-5352
(304) 893-9777
Mailing address
425 JULIANA ST, PARKERSBURG, WV 26101-5352
(304) 893-9777
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
190022
OH
Other
Enumeration date
09/24/2025
Last updated
09/24/2025
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