Individual
MEGAN SHANNON SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
167 GLENDALE ST, UXBRIDGE, MA 01569-2124
(978) 870-3642
Mailing address
167 GLENDALE ST, UXBRIDGE, MA 01569-2124
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2280110
MA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN2280110
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/06/2020
Last updated
05/05/2021
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