Individual provider · Type 1 NPI

Michael John Sullivan, AGANP-C

Acute Care Nurse Practitioner · Carrollton, GA

NPI number 1780043463 Active

Practice location

705 Dixie St, Suite 401
Carrollton, GA 30117-3818

Mailing address

119 Ambulance Dr, Suite 202
Carrollton, GA 30117-3857

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner 363LG0600XRN209135 (GA)
Acute Care Nurse Practitioner Primary 363LA2100XRN209135 (GA)

Acute Care Nurse Practitioner: Definition to come...

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About NPI 1780043463

Michael John Sullivan, AGANP-C's National Provider Identifier is 1780043463, issued on Feb 23, 2016. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Carrollton, GA. The record was last updated on Mar 2, 2016.