Sullins, Lisia A

Sullins, Lisia A is an individual health care provider with primary practice located at 7000 Wellness Way Suite 130, St Simons Island GA 31522-2286. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Sullins, Lisia A can be contacted via phone (912) 638-4855.

Contact Information

Primary practice address
7000 Wellness Way Suite 130 St Simons Island GA 31522-2286
Phone: (912) 638-4855
Fax: (912) 638-8302
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN112143 Georgia

Profile Details

NPI number 1609937499
LBN Legal business name Sullins, Lisia A
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Jan 8th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609937499 NPPES
Georgia MEDICAID 000190209B

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