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Individual

MRS. DEBORAH S SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
1306 MAPLE ST, ELDORADO, IL 62930-1662
(618) 273-3361
Mailing address
1239 E MAIN ST, CARBONDALE, IL 62901-3175
(618) 457-5200
(618) 529-0586

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209007892
IL
363LX0106X
Occupational Health Nurse Practitioner
209.007892
IL

Other

Enumeration date
01/12/2010
Last updated
02/12/2024
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