Individual
NANCY L. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12720 MCMANUS BLVD, SUITE 311, NEWPORT NEWS, VA 23602-4414
(757) 947-3170
(757) 947-3180
Mailing address
7007 HARBOUR VIEW BLVD, SUITE 108, SUFFOLK, VA 23435-2719
(757) 215-2784
(757) 215-2728
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024067080
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457504433
—
VA
Enumeration date
11/04/2008
Last updated
07/14/2014
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