Individual
COURTNEY D SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
8111 DODGE ST, SUITE 363, OMAHA, NE 68114-4129
(402) 354-8155
Mailing address
7261 MERCY RD, SUITE 363, OMAHA, NE 68124-2311
(402) 398-6255
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
111234
NE
363LA2100X
Acute Care Nurse Practitioner
209007230
IL
Other
Enumeration date
08/27/2008
Last updated
09/22/2016
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