Individual
COURTNEY SULLENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
222 W MICHIGAN ST, INDIANAPOLIS, IN 46204-1254
(317) 779-0303
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001636A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300100824
—
IN
Enumeration date
03/12/2014
Last updated
04/07/2025
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