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General NPI Number Information
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NPI Number | 1992119861
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Entity Type | Individual
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Provider Name | SHEILA SULLIVAN LPN
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Gender | Female
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 610 OLD GREENVILLE RD
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City | SPARTANBURG
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State | SC
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Zip | 29301-4704
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Country | US
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Telephone | 864-205-2456
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Fax | 864-327-8214
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Provider Business Mailing Address
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Address Line | 610 OLD GREENVILLE RD
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City | SPARTANBURG
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State | SC
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Zip | 29301-4704
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Country | US
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Telephone | 864-205-2456
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Fax | 864-327-8214
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 16570
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | P16570
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License Number State | SC
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