Individual
PROF. AJA BLUE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1 BARNES JEW HOSP PLZ, SAINT LOUIS, MO 63110-1003
(314) 749-7088
Mailing address
4483 DUNCAN AVE, SAINT LOUIS, MO 63110-1111
(314) 749-7088
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2014017173
MO
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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