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General NPI Number Information
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NPI Number | 1437177417
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Entity Type | Individual
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Provider Name | ANN LAWRENCE OSULLIVAN PHD CRNP FAAN
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3400 CIVIC CENTER BLVD
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4306
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Country | US
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Telephone | 215-590-5035
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Fax | 215-590-5048
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Provider Business Mailing Address
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Address Line | 335 S 4TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19106-4219
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Country | US
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Telephone | 215-285-1071
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Fax | 215-573-7496
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | VP000285D
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License Number State | PA
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