Individual
GABRIELLE L SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
637 DAVISON RD, LOCKPORT, NY 14094-5339
(716) 433-2484
Mailing address
55 DODGE RD, GETZVILLE, NY 14068-1205
(716) 831-2700
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F403775-01
NY
Other
Enumeration date
01/01/2022
Last updated
06/13/2022
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