Individual
COLLEEN MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2076 HIGHWAY 42 WEST, CLAYTON, NC 27520-5302
(919) 763-1050
Mailing address
PO BOX 5105, BELFAST, ME 04915-5100
(919) 220-5255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
104145
NC
Other
Enumeration date
08/03/2006
Last updated
01/28/2022
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