Individual
LAURA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, PLYMOUTH MEETING, PA 19462-1047
(800) 879-4471
Mailing address
4813 MILLERS STATION RD, HAMPSTEAD, MD 21074-1207
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R104503
MD
Other
Enumeration date
07/31/2009
Last updated
07/31/2009
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