Individual
ASHANTI SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5 GORHAM CT, SIMPSONVILLE, SC 29680-7914
(864) 631-6832
Mailing address
5 GORHAM CT, SIMPSONVILLE, SC 29680-7914
(864) 631-6832
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
89903
SC
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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