Individual
AMANDA MICHELLE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
411 E CHESTNUT ST # STREET2, LOUISVILLE, KY 40202-1713
(502) 588-0982
(502) 588-0987
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
3018470
KY
363LN0000X
Neonatal Nurse Practitioner
ARNP9353428
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003135006B
—
GA
05
—
008891500
—
FL
Enumeration date
05/24/2013
Last updated
11/18/2024
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