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NPI Code Detail

MEDICARE: BETH CARRIERE SULLIVAN FNP

MEDICARE: BETH CARRIERE SULLIVAN FNP
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
1363LF0000XFamily Nurse PractitionerAP05897LA

General Provider Information

NPI Number : 1427280726
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH CARRIERE SULLIVAN FNP
Provider Business Mailing Address
First Line : 1330 CARROLLTON AVE
Second Line :
City : METAIRIE
State : LA
Zip : 70005-1861
Country : US
Telephone Number : 504-834-1884
Fax Number :
Provider Business Practice Location Address
First Line : 1525 DICKORY AVE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70123-2168
Country : US
Telephone Number : 504-818-0006
Fax Number : 504-818-0095
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2009
Last Update Date : 08/20/2009

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Directions to “ BETH CARRIERE SULLIVAN FNP” Practice Location

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