Individual
MEGHAN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
12855 N 40 DR STE 280, SAINT LOUIS, MO 63141-8657
(314) 432-4415
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(314) 432-4415
(314) 432-1986
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2014018618
MO
363LF0000X
Family Nurse Practitioner
2014018618
MO
Other
Enumeration date
06/14/2014
Last updated
04/25/2025
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