Individual
LAURA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
600 SOUTH DR, FORT COLLINS, CO 80523-0001
(970) 491-7121
Mailing address
PO BOX 248, TIMNATH, CO 80547
(970) 219-4809
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN0180186
CO
Other
Enumeration date
03/02/2015
Last updated
03/02/2015
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