Individual
KAITLYN MARIE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
738 LITTLE DEER CREEK VALLEY RD, RUSSELLTON, PA 15076-1333
(724) 265-1632
(724) 265-1120
Mailing address
2922 MANUEL DR, ALLISON PARK, PA 15101-4154
(814) 952-9237
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP452064
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1036260510001
—
PA
Enumeration date
05/12/2018
Last updated
04/10/2024
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