Individual provider · Type 1 NPI

Samuel Sullivan

Licensed Practical Nurse · Salem, OR

NPI number 1730775495 Active

Practice location

1750 Mcgilchrist St SE Ste 130
Salem, OR 97302-1691

Call (971) 304-2200 Map

Mailing address

1332 Lydia Ave N
Keizer, OR 97303-7550

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X202007792LPN (OR)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1730775495

Samuel Sullivan's National Provider Identifier is 1730775495, issued on Dec 16, 2020. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Salem, OR. The record was last updated on Dec 16, 2020.