Individual
CASEY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6911 E US HIGHWAY 36, AVON, IN 46123-8926
(317) 272-8033
(317) 272-8044
Mailing address
1100 SOUTHFIELD DR STE 1370, PLAINFIELD, IN 46168-4300
(317) 837-5566
(317) 837-5580
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002030A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200865470
—
IN
Enumeration date
07/16/2007
Last updated
03/17/2021
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