Sullivan, Amy
Sullivan, Amy is an individual health care provider with primary practice located at 5830 Highway 5 , Cabot AR 72023-7328. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Sullivan, Amy can be contacted via phone (501) 941-1376.Contact Information
Primary practice address
5830 Highway 5
Cabot AR 72023-7328
Phone: (501) 941-1376
Fax: (870) 569-3594
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | A004030 | Arkansas |
Profile Details
| NPI number | 1053735639 |
|---|---|
| LBN Legal business name | Sullivan, Amy |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 18th, 2014 |
| Last updated | Jun 16th, 2018 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053735639 | NPPES |
| Arkansas | MEDICAID | 201310758 |
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