Individual
MS. MAUREEN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, WHNP
Contact information
Practice address
1919 LATHROP ST, SUITE 217, FAIRBANKS, AK 99701-5937
(907) 456-8191
(907) 456-8192
Mailing address
1919 LATHROP ST, STE 222, FAIRBANKS, AK 99701-5942
(907) 456-8191
(907) 456-8192
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
F420761-1
NY
367A00000X
Advanced Practice Midwife
Primary
1085
AK
367A00000X
Advanced Practice Midwife
APN36126
MT
367A00000X
Advanced Practice Midwife
F001104-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02494035
—
NY
Enumeration date
04/06/2006
Last updated
10/11/2016
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