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NPI Code Detail

MEDICARE: HEATHER T SULLIVAN

MEDICARE: HEATHER T SULLIVAN
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
1183500000XPharmacist25061NV

General Provider Information

NPI Number : 1366370546
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER T SULLIVAN
Provider Business Mailing Address
First Line : 442 SPRING DOVE AVE
Second Line :
City : HENDERSON
State : NV
Zip : 89011-4542
Country : US
Telephone Number : 702-480-7321
Fax Number : 702-480-7321
Provider Business Practice Location Address
First Line : 401 N ARROYO GRANDE BLVD
Second Line :
City : HENDERSON
State : NV
Zip : 89014-3974
Country : US
Telephone Number : 702-436-7106
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2026
Last Update Date : 05/11/2026

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Directions to “ HEATHER T SULLIVAN ” Practice Location

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