Individual
JULIA W SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1200 J D ANDERSON DR, MORGANTOWN, WV 26505-3494
(304) 346-9400
(304) 345-7320
Mailing address
101 STADIUM DR, MORGANTOWN, WV 26506-7911
(304) 346-9400
(304) 720-8461
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
47812
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1019415650001
—
PA
01
—
1073294
WORKERS COMP
WV
05
—
2742198
—
OH
05
—
3810008943
—
WV
05
—
412266600
—
MD
Enumeration date
03/22/2007
Last updated
03/29/2016
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