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NPI Code Detail

MEDICARE: DANIELLE NICOLE SULLIVAN

MEDICARE: DANIELLE NICOLE 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
1363LX0001XObstetrics & Gynecology Nurse PractitionerGA339973GA
2163W00000XRegistered NurseRN9565528FL

General Provider Information

NPI Number : 1801639976
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE NICOLE SULLIVAN
Provider Business Mailing Address
First Line : 414 5TH AVE
Second Line :
City : ALBANY
State : GA
Zip : 31701-1976
Country : US
Telephone Number : 229-883-4555
Fax Number : 229-888-0063
Provider Business Practice Location Address
First Line : 414 5TH AVE
Second Line :
City : ALBANY
State : GA
Zip : 31701-1976
Country : US
Telephone Number : 229-883-4555
Fax Number : 229-888-0063
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2024
Last Update Date : 04/15/2026

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Directions to “ DANIELLE NICOLE SULLIVAN ” Practice Location

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