Individual
KRISTEN RUDICK SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, CRNP
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-8765
(774) 443-7360
Mailing address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-8765
(774) 443-7360
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN284023
MA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN284023
MA
363LP0200X
Pediatric Nurse Practitioner
RN284023
MA
Other
Enumeration date
12/01/2011
Last updated
03/29/2022
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