Individual
DR. DONNA L SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1025 PENNOCK PL, FORT COLLINS, CO 80524-3257
(970) 495-8800
(970) 495-8820
Mailing address
1025 PENNOCK PL, FORT COLLINS, CO 80524-3257
(970) 495-8800
(970) 495-8820
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30139
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01301399
—
CO
Enumeration date
01/03/2006
Last updated
06/12/2014
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