Individual
BETHANY S. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4851 KY ROUTE 321, PRESTONSBURG, KY 41653-9113
(606) 886-1173
(606) 886-2193
Mailing address
PO BOX 697, PRESTONSBURG, KY 41653-0697
(606) 886-1173
(606) 886-2193
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007834
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100229990
—
KY
Enumeration date
01/25/2013
Last updated
08/16/2017
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