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Individual

MRS. NAOMI LEIGH SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
300 HEALTH PARK BLVD STE 3002, ST AUGUSTINE, FL 32086-3703
(904) 819-1500
(904) 810-1023
Mailing address
300 HEALTH PARK BLVD STE 3002, ST AUGUSTINE, FL 32086-3703
(904) 819-1500

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
0024172420
VA
367A00000X
Advanced Practice Midwife
Primary
1487050621
FL
367A00000X
Advanced Practice Midwife
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016981400
FL
Enumeration date
11/17/2014
Last updated
10/03/2023
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