Individual
MRS. LYNSEY RENEE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1337 S SAM HOUSTON BLVD, HOUSTON, MO 65483-2046
(417) 967-5435
(417) 967-5503
Mailing address
1337 S SAM HOUSTON BLVD, HOUSTON, MO 65483-2046
(417) 967-5435
(417) 967-5503
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2016038317
MO
363LF0000X
Family Nurse Practitioner
F09161375
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26D0889777
CLIA
MO
05
—
420039764
—
MO
Enumeration date
12/28/2016
Last updated
02/14/2023
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