Individual
BRENT SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
308 CHERUBIC WAY, ROLESVILLE, NC 27571
(919) 520-7445
Mailing address
1812 ARMOR CREST LN, WAKE FOREST, NC 27587-1841
(919) 520-7445
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
—
—
Other
Enumeration date
07/21/2026
Last updated
07/21/2026
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