Individual
MS. AMANDA MARIE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11 WINFIELD ST, SOUTH BOSTON, MA 02127-4125
(617) 268-6084
Mailing address
64 SUMNER AVE, BRAINTREE, MA 02184-6224
(617) 610-7009
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2259241
MA
Other
Enumeration date
05/05/2009
Last updated
05/05/2009
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