Individual
HEIDI SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
102 BRYAN WOODS ROAD, SAVANNAH, GA 31410-1225
(912) 898-1122
(912) 898-9944
Mailing address
836 E. 65TH STREET, SUITE 20, SAVANNAH, GA 31405
(912) 819-7878
(912) 819-3555
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN106514
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003181045B
—
GA
Enumeration date
07/22/2016
Last updated
05/22/2019
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