Individual provider · Type 1 NPI
Carolyn Anne Sullivan, AC PNP
Critical Care Pediatric Nurse Practitioner · Springfield, MO
NPI number
1225306269
Active
Practice location
3231 S National Ave, Suite 115
Springfield, MO 65807-7304
Fax (417) 890-4174
Mailing address
PO Box 505164
St. Louis, MO 63150-5164
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Critical Care Pediatric Nurse Practitioner | 363LP0222X | 209009257 (IL) |
| Critical Care Pediatric Nurse Practitioner Primary | 363LP0222X | 2015003901 (MO) |
Critical Care Pediatric Nurse Practitioner: Definition to come...
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About NPI 1225306269
Carolyn Anne Sullivan, AC PNP's National Provider Identifier is 1225306269, issued on Dec 5, 2011. The primary taxonomy on file is Critical Care Pediatric Nurse Practitioner (363LP0222X), and the practice location is in Springfield, MO. The record was last updated on Nov 19, 2015.