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NPI Code Detail

MEDICARE: MS. JOANNE SULLIVAN RN

MEDICARE: MS. JOANNE SULLIVAN RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse6991AK

General Provider Information

NPI Number : 1689087462
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JOANNE SULLIVAN RN
Provider Business Mailing Address
First Line : 540 W INTERNATIONAL AIRPORT RD
Second Line : C/O HOPE COMMUNITY RESOURCES, INC
City : ANCHORAGE
State : AK
Zip : 99518-1105
Country : US
Telephone Number : 907-561-5335
Fax Number : 907-272-8807
Provider Business Practice Location Address
First Line : 540 W INTERNATIONAL AIRPORT RD
Second Line : C/O HOPE COMMUNITY RESOURCES, INC
City : ANCHORAGE
State : AK
Zip : 99518-1105
Country : US
Telephone Number : 907-561-5335
Fax Number : 907-272-8807
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2014
Last Update Date : 06/09/2014

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