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Individual

LAURA MICHELE SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
11 VANDERBILT PARK DR, ASHEVILLE, NC 28803-1700
(828) 213-1740
(828) 213-1742
Mailing address
143 STATE ST, ASHEVILLE, NC 28806-3341
(828) 213-1740

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5010250
NC
363LN0000X
Neonatal Nurse Practitioner
5010250
NC
363LN0000X
Neonatal Nurse Practitioner
99797
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1467847871
NC
Enumeration date
04/02/2015
Last updated
05/11/2018
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