Individual
JOANNE MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
950 WINTER ST, SUITE 3800, WALTHAM, MA 02451-1424
(781) 472-8515
Mailing address
950 WINTER ST, SUITE 3800, WALTHAM, MA 02451-1424
(781) 472-8515
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
225133
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0374130
—
MA
Enumeration date
12/27/2006
Last updated
07/20/2015
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