Individual
MRS. CRYSTAL LYNN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1446 NW CATAWBA RD, PORT CLINTON, OH 43452-2820
(419) 271-3968
Mailing address
1446 NW CATAWBA RD, PORT CLINTON, OH 43452-2820
(419) 271-3968
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
146058
OH
Other
Enumeration date
03/18/2019
Last updated
03/18/2019
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