Individual
MRS. TENEIL RACHELLE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1432 E 2ND ST UNIT A, CASPER, WY 82601-2961
(307) 351-1359
Mailing address
PO BOX 672, MILLS, WY 82644-0672
(307) 351-1359
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
47829
WY
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
04/10/2020
Last updated
01/17/2025
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