Individual
APRIL DAWN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1111 WALNUT DR, ARDMORE, OK 73401-2354
(580) 223-9008
Mailing address
467 FARLAND ST, ARDMORE, OK 73401-1460
(580) 320-0854
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3209
OK
Other
Enumeration date
05/28/2020
Last updated
05/28/2020
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