Individual
ALEX BRENNAN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 782-3282
Mailing address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 782-3282
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN682784
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN682784
PA
Other
Enumeration date
04/13/2021
Last updated
07/23/2021
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