Individual
JANNA MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
75 CLAREMONT ST, KALISPELL, MT 59901-3585
(406) 752-8282
(406) 257-2225
Mailing address
113 E WYOMING ST, KALISPELL, MT 59901-3765
(406) 752-8282
(406) 257-2225
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN9728
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4302415
—
MT
Enumeration date
06/29/2006
Last updated
07/08/2007
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