Individual
MRS. KAY ELLEN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS APN
Contact information
Practice address
215 BROADWAY, GARY, IN 46402-1221
(219) 888-5975
(219) 888-4197
Mailing address
592 GLENWOOD DR, VALPARAISO, IN 46385-8878
(219) 759-4276
Taxonomy
Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
Primary
71000500A
IN
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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