| Doctor Name: | BRITTANY ANN SULLIVAN |
| NPI Number: | 1063859452 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | |
| Business Practice Address: | 6159 1st Financial Dr Burlington, KY - 410057892 |
| Business Phone Number: | 8595868200 |
| Business Fax Number: | 8595868233 |
| Mailing Address: | 2300 Chamber Center Dr, LAKESIDE PARK |
| State: | KY |
| Postal Code: | 410171686 |
| Phone Number: | 8593445555 |
| Fax Number: | 8595868233 |
| NPI Enumeration Date: | 05/27/2013 |
| NPI Last Update Date: | 08/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |