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Individual

MR. JARED DANIEL SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1400 LOCUST ST, PITTSBURGH, PA 15219-5114
(412) 232-8111
Mailing address
1400 LOCUST ST, PITTSBURGH, PA 15219-5114
(412) 232-8111

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN617149
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
100837
PA

Other

Enumeration date
01/17/2014
Last updated
01/17/2014
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