Individual
LAUREN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2204 PAVILION DR, SUITE 105, KINGSPORT, TN 37660-4657
(423) 392-6109
Mailing address
2204 PAVILION DR, SUITE 105, KINGSPORT, TN 37660-4657
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202211353
VA
183500000X
Pharmacist
Primary
35736
TN
Other
Enumeration date
03/02/2013
Last updated
04/10/2024
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