Healthcare Provider Details

I. General information

NPI: 1750543294
Provider Name (Legal Business Name): RACHEL M. SULLIVAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-BH, CAFBHS
HONOLULU HI
96859-0000
US

IV. Provider business mailing address

1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-BH, CAFBHS
HONOLULU HI
96859-0000
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-6418
  • Fax:
Mailing address:
  • Phone: 808-433-6418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25421
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number25421
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number25421
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: