Individual
AMBER SULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2250 N 1700 W, LAYTON, UT 84041-1140
(801) 773-7060
(801) 336-1774
Mailing address
2250 N 1700 W, LAYTON, UT 84041-1140
(801) 773-7060
(801) 336-1774
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
9022621-3101
UT
Other
Enumeration date
06/27/2014
Last updated
06/27/2014
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