Individual
MRS. CARISA R SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6010 W AMARILLO BLVD BLDG WEST, AMARILLO, TX 79106-1990
(806) 355-9703
(806) 468-1500
Mailing address
6010 W AMARILLO BLVD BLDG WEST, AMARILLO, TX 79106-1990
(806) 355-9703
(806) 468-1500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP129122
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200615620 A
—
OK
05
—
352922401
—
TX
05
—
352922402
—
TX
05
—
77376714
—
NM
Enumeration date
09/29/2015
Last updated
02/11/2020
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