Individual
RACHEL SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3 FULFORD CIR, BELLA VISTA, AR 72715-6911
(479) 544-7968
Mailing address
3 FULFORD CIR, BELLA VISTA, AR 72715-6911
(479) 544-7968
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4000715
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/20/2022
Last updated
04/25/2024
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