Individual
COLBY KEITH SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
5149 N 9TH AVE, PENSACOLA, FL 32504-8756
(850) 479-7200
Mailing address
PO BOX 11982, PENSACOLA, FL 32524-1982
(850) 479-1805
(850) 479-1829
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11002698
FL
Other
Enumeration date
08/05/2019
Last updated
01/04/2022
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