| Doctor Name: | MRS. DEBORAH LEE SULLIVAN |
| NPI Number: | 1093950420 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | NP891 |
| Business Practice Address: | 211 E Logan St Suite 105 Caldwell, ID - 836054882 |
| Business Phone Number: | 2084540567 |
| Business Fax Number: | 2084026635 |
| Mailing Address: | 3706 N Stone Creek Way, BOISE |
| State: | ID |
| Postal Code: | 837034745 |
| Phone Number: | 2085143217 |
| Fax Number: | |
| NPI Enumeration Date: | 12/15/2008 |
| NPI Last Update Date: | 05/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SF0001X |
| License Number: | NP891 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Family Health |
| Taxonomy Definition: | |