Individual
KRISTEN T SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-2693
(602) 933-2697
Mailing address
3200 E CAMELBACK RD STE 250, PHOENIX, AZ 85018-2327
(602) 933-1814
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
RN159067
AZ
363LP0200X
Pediatric Nurse Practitioner
AP3435
AZ
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
AP3435
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
471784
—
AZ
Enumeration date
09/03/2009
Last updated
03/29/2018
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