Individual
BRANDEE STARR SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2900 16TH ST, BEDFORD, IN 47421-3510
(812) 278-8800
Mailing address
2900 16TH ST, BEDFORD, IN 47421-3510
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
71008403A
IN
363LP2300X
Primary Care Nurse Practitioner
Primary
71008403A
IN
Other
Enumeration date
09/28/2018
Last updated
05/30/2023
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