Individual
NANCY L SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
295 ESSJAY RD, WILLIAMSVILLE, NY 14221-8216
(716) 630-1045
(716) 630-1451
Mailing address
425 ESSJAY RD STE 170, WILLIAMSVILLE, NY 14221-8235
(716) 630-1219
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F303529-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026526201
UNIVERA
NY
01
—
000560711001
HEALTH NOW
NY
05
—
02292157
—
NY
01
—
161000580
GHI
NY
01
—
9512257
IHA
NY
Enumeration date
08/03/2006
Last updated
12/14/2021
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