Individual
DAVID YUTAKA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-6230
(928) 289-6229
Mailing address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-6230
(928) 289-6229
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
RN174273
AZ
363LF0000X
Family Nurse Practitioner
Primary
224965
AZ
Other
Enumeration date
08/29/2012
Last updated
04/25/2019
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