Individual
BEVIN ANNE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
31 TIOGA STREET, GROUND FLOOR, STANTEN ISLAND, NY 10301-4352
(718) 450-0172
Mailing address
31 TIOGA STREET, GROUND FLOOR, STANTEN ISLAND, NY 10301-4352
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
432876
NY
363LF0000X
Family Nurse Practitioner
Primary
432876
NY
363LP2300X
Primary Care Nurse Practitioner
432876
NY
Other
Enumeration date
03/01/2024
Last updated
09/24/2024
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