Individual
CARLY MICHELLE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
218 HOWLE AVE, CHARLESTON, SC 29412-2449
(854) 444-0518
Mailing address
33 N JEFFERSON ST, CARTHAGE, NY 13619-1131
(315) 771-5266
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
351948
NY
Other
Enumeration date
09/12/2023
Last updated
09/12/2023
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