Individual
COURTNEY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
262 DANNY THOMAS PL, MAIL STOP 721, MEMPHIS, TN 38105-3678
(901) 595-7510
(901) 595-5319
Mailing address
2204 COWDEN AVE, APARTMENT 2, MEMPHIS, TN 38104-5367
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
18080
TN
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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