Individual
MARY JEAN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-7024
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-7024
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
148881
MA
Other
Enumeration date
01/03/2008
Last updated
01/03/2008
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