Individual
AMY E. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CDE
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 442-0711
(960) 444-4775
Mailing address
2 LORENZ INDUSTRIAL PARKWAY, LEDYARD, CT 06339-1946
(860) 464-3045
(860) 464-3044
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
E54734
CT
163WD0400X
Diabetes Educator Registered Nurse
Primary
E54734
CT
Other
Enumeration date
05/26/2009
Last updated
05/26/2009
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