Individual
KRISTINA SULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2801 W BANCROFT ST, MS 513, TOLEDO, OH 43606-3328
(419) 530-3451
(419) 530-3499
Mailing address
1 STABLESIDE S, OTTAWA HILLS, OH 43615-2165
(419) 531-9080
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
111067
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2189644
—
OH
Enumeration date
03/05/2007
Last updated
07/08/2007
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