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Individual

MRS. KENDRA LYNN SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
101 E PLUMMER BLVD, CHATHAM, IL 62629-8047
(217) 483-3487
Mailing address
101 E PLUMMER BLVD, CHATHAM, IL 62629-8047
(217) 483-3487

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209013990
IL

Other

Enumeration date
03/07/2016
Last updated
03/09/2016
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