Individual
MRS. KIMBERLY AFUA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
7535 W BROADWAY AVE, BROOKLYN PARK, MN 55428-1287
(763) 425-5300
Mailing address
7535 W BROADWAY AVE, BROOKLYN PARK, MN 55428-1287
(763) 425-5300
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
122422
MN
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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