Individual provider · Type 1 NPI

Mary Ellen Sullivan, GNP-BC

Gerontology Nurse Practitioner · Columbia, SC

NPI number 1861676942 Active

Practice location

111 Doctor Cir
Columbia, SC 29203-6502

Specialties and licenses

Taxonomy	Code	License
Gerontology Nurse Practitioner Primary	363LG0600X	3428 (SC)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1861676942

Mary Ellen Sullivan, GNP-BC's National Provider Identifier is 1861676942, issued on Dec 25, 2007. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Columbia, SC. The record was last updated on Nov 9, 2022.