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General NPI Number Information
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NPI Number | 1255055760
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Entity Type | Individual
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Provider Name | ALLISON SULLIVAN PA
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Gender | Female
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Dates
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Enumeration Date | 09/28/2022
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 120 N CAROLINA ST
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City | NEW ROADS
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State | LA
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Zip | 70760-3604
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Country | US
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Telephone | 225-713-4044
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Fax | 225-208-1188
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Provider Business Mailing Address
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Address Line | 302 HACKER ST
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City | NEW IBERIA
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State | LA
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Zip | 70560-4508
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Country | US
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Telephone | 337-330-2576
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Fax | 337-417-9909
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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