Individual
KERRIE L SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CFNP MSN
Contact information
Practice address
1000 BESTGATE RD STE 400, ANNAPOLIS, MD 21401
(410) 266-2720
(410) 224-0209
Mailing address
1000 BESTGATE RD STE 400, ANNAPOLIS, MD 21401-3371
(410) 266-2720
(410) 224-0209
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R121234
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
411894400
—
MD
01
—
88989503
BCBS MD
—
01
—
88989504
BCBS
MD
01
—
88989506
BCBS
MD
01
—
88989507
BCBS
MD
01
—
D3800008
BCBS
DC
01
—
J4570008
BCBS DC
—
01
—
W8490005
BCBS
DC
Enumeration date
09/20/2006
Last updated
11/26/2018
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