Sullivan, Amanda Renee

Sullivan, Amanda Renee is an individual health care provider with primary practice located at 9200 W Wisconsin Ave , Milwaukee WI 53226-3522. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Sullivan, Amanda Renee can be contacted via phone (414) 805-4050.

Contact Information

Primary practice address
9200 W Wisconsin Ave Milwaukee WI 53226-3522
Phone: (414) 805-4050
Fax: (414) 805-0855
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 11297 Wisconsin

Profile Details

NPI number 1538837166
LBN Legal business name Sullivan, Amanda Renee
Credentials AGACNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2021
Last updated Mar 23rd, 2023 - about 2 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 1538837166 NPPES
Wisconsin MEDICAID 1538837166

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