Individual
MRS. LOIS WALTERS SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2503 N QUEEN ST, KINSTON, NC 28501-1632
(252) 523-6000
(252) 527-8500
Mailing address
2000 PERIMETER PARK DR STE 200, MORRISVILLE, NC 27560-8442
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
300327
NC
363LA2200X
Adult Health Nurse Practitioner
Primary
300327
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7000990
—
NC
Enumeration date
11/22/2005
Last updated
07/18/2023
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