Individual provider · Type 1 NPI

Icel R. Sullivan, ARNP

Pediatric Nurse Practitioner · Richland, WA

NPI number 1770116436 Active

Practice location

888 Swift Blvd
Richland, WA 99352-3514

Mailing address

550 Gage Blvd Ste 101
Richland, WA 99352-9532

Other practice locations

  • 1911 Cooks Hill Rd, Centralia, WA 98531-9073 · (360) 736-6778

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000XRN00164194 (WA)
Pediatric Nurse Practitioner Primary 363LP0200XAP61060250 (WA)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1770116436

Icel R. Sullivan, ARNP's National Provider Identifier is 1770116436, issued on Feb 20, 2020. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Richland, WA. The record was last updated on Nov 11, 2021.