Individual
MRS. JILL R SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPH
Contact information
Practice address
6985 RHEA COUNTY HWY, DAYTON, TN 37321-6208
(423) 775-5511
(423) 775-5204
Mailing address
PO BOX 1045, DAYTON, TN 37321-1003
(423) 775-5511
(423) 775-5204
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
24210
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
244869
NABP
TN
Enumeration date
09/15/2017
Last updated
06/16/2018
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