Individual
KATHLEEN M SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3400 SPRUCE ST, RHOADS 5, PHILADELPHIA, PA 19104-4238
(215) 662-6574
Mailing address
3400 SPRUCE ST, RHOADS 5, PHILADELPHIA, PA 19104-4238
(215) 662-6574
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP015828
PA
Other
Enumeration date
12/16/2015
Last updated
02/15/2016
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