Sullivan, Joanne Marie

Sullivan, Joanne Marie is an individual health care provider with primary practice located at 950 Winter St Suite 3800, Waltham MA 02451-1424. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Sullivan, Joanne Marie can be contacted via phone (781) 472-8515.

Contact Information

Primary practice address
950 Winter St Suite 3800 Waltham MA 02451-1424
Phone: (781) 472-8515
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 225133 Massachusetts

Profile Details

NPI number 1427113539
LBN Legal business name Sullivan, Joanne Marie
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2006
Last updated Jul 20th, 2015 - about 10 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 1427113539 NPPES
Massachusetts MEDICAID 0374130

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