Individual
BRANDY W SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
110 29TH AVE N STE 202, NASHVILLE, TN 37203-1448
(615) 327-4304
Mailing address
110 29TH AVE N STE 202, NASHVILLE, TN 37203-1448
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
13005
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3600163
—
TN
01
—
4171083
BCBS
TN
01
—
620931432
TRICARE REGION SOUTH
TN
05
—
7100032120
—
KY
Enumeration date
01/08/2008
Last updated
10/02/2017
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