Doctor Name: | PAIGE NELLEEN SULLIVAN |
NPI Number: | 1699977900 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SUL732806 |
Business Practice Address: | 933 5th Ave Cando, ND - 583246116 |
Business Phone Number: | 7019683573 |
Business Fax Number: | |
Mailing Address: | 933 5th Ave, CANDO |
State: | ND |
Postal Code: | 583246116 |
Phone Number: | 7019683573 |
Fax Number: | |
NPI Enumeration Date: | 05/31/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 172A00000X |
License Number: | SUL732806 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Driver |
Taxonomy Specialization: | |
Taxonomy Definition: | A person employed to operate a motor vehicle as a carrier of persons or property. |