Individual provider · Type 1 NPI
Mary Sullivan
Nurse Practitioner · Portage, MI
Practice location
8001 Angling Road
Portage, MI 49024
Mailing address
5943 Stadium Drive, Suite 3
Kalamazoo, MI 49009
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 4704209403 (MI) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1275627713
Mary Sullivan's National Provider Identifier is 1275627713, issued on Oct 2, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Portage, MI. The record was last updated on Jul 8, 2007.