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Individual

AMY E SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
1050 HANSON ST, WINNEMUCCA, NV 89445-2774
(756) 253-9377
(775) 625-3938
Mailing address
1050 HANSON ST, WINNEMUCCA, NV 89445-2774
(756) 253-9377
(775) 625-3938

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
797
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1699050740
NV
Enumeration date
10/19/2011
Last updated
04/05/2022
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