Individual
KATHERINE FRANCES SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
9047 EXECUTIVE PARK DR STE 210, KNOXVILLE, TN 37923-4625
(865) 773-3555
(865) 297-4240
Mailing address
9047 EXECUTIVE PARK DR STE 210, KNOXVILLE, TN 37923-4625
(865) 773-3555
(865) 297-4240
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
173200
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
15830
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1031503917
MEDICARE
TN
05
—
1524466
—
TN
Enumeration date
05/17/2010
Last updated
03/04/2020
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