Individual
ANNA NICOLE POWELL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
310 COMAL ST STE 200, AUSTIN, TX 78702-4599
(737) 270-9500
(833) 906-2436
Mailing address
129 LEACROFT WAY, DURHAM, NC 27703-6703
(919) 656-5170
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-11205
NC
Other
Enumeration date
04/23/2021
Last updated
07/23/2024
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