Amanda Marie Sullivan L.P.N,

NPI 1407121221 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1407121221
Gender Female
Enumeration Date 03/12/2012
Last Updated 03/13/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
610 N MAIN ST
FALL RIVER WI, 53932-9570, US
Phone (920) 382-5666
Fax
Business Location
610 N MAIN ST
FALL RIVER WI, 53932-9570, US
Phone (920) 382-5666
Fax
Toxanomy
Taxonomy Code 164W00000X
License State Wisconsin
License Number 304840-31
Remove 1407121221 NPI Number
 

According to our database, Mrs. Amanda Marie Sullivan L.P.N, NPI is 1407121221, taxonomy code is 164W00000X and license number is 304840-31, license state is located at Wisconsin. Amanda Marie Sullivan L.P.N, physically located at 610 N Main St, Fall River WI, 53932-9570. NPI Number Amanda Marie Sullivan L.P.N, has the Individual type.

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1407121221 NPI number is provided on an as is basis without warranty of any kind. 1407121221 is maintained by the National Plan & Provider Enumeration System. The contents of Amanda Marie Sullivan L.P.N, are for informational purposes only.