Individual
LAURA A SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
DEPT OF VET AFFAIRS WIREGRASS HBPC, 301 ANDREWS AVENUE, FORT RUCKER, AL 36362
(334) 272-4670
(334) 503-7869
Mailing address
102 STILL WATER DR, ENTERPRISE, AL 36330-8314
(334) 434-2417
(334) 503-7869
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-093306
AL
Other
Enumeration date
06/29/2005
Last updated
07/23/2020
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