Individual
JACQUELINE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
615 E CROSSTOWN PKWY, KALAMAZOO, MI 49001-2501
(269) 553-7016
Mailing address
615 E CROSSTOWN PKWY, KALAMAZOO, MI 49001-2501
(269) 553-7016
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704377710
MI
Other
Enumeration date
07/08/2019
Last updated
12/08/2022
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