Individual
SHANNON SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
20196000263
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
273201143
BUSINESS TAX ID
CO
Enumeration date
06/17/2019
Last updated
06/17/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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