Individual
JAMES SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R882067
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
901358
MS
Other
Enumeration date
11/20/2015
Last updated
05/27/2021
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