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
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | RN00164194 (WA) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | AP61060250 (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.