Individual
MARGARET M SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
770 CENTRE ST, JAMAICA PLAIN, MA 02130-2706
(617) 524-2121
(617) 524-3810
Mailing address
19 EMMONSDALE RD, WEST ROXBURY, MA 02132-2975
(617) 325-7582
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
207233
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0388921
—
MA
Enumeration date
02/12/2007
Last updated
07/08/2007
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