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Individual

ASHATE RENEE SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1275 LAKESIDE AVE E, CLEVELAND, OH 44114-1129
(216) 548-1808
Mailing address
24480 UPPINGHAM RD, BEDFORD HEIGHTS, OH 44146-4072
(216) 548-1808

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
188712
OH

Other

Enumeration date
08/19/2024
Last updated
08/19/2024
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