Sullivan, Melody L

Sullivan, Melody L is an individual health care provider with primary practice located at 477 23Rd St , Ogden UT 84401-1507. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Sullivan, Melody L can be contacted via phone (801) 399-7109.

Contact Information

Primary practice address
477 23Rd St Ogden UT 84401-1507
Phone: (801) 399-7109
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 341490-3102 Utah

Profile Details

NPI number 1750545596
LBN Legal business name Sullivan, Melody L
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2008
Last updated Jul 10th, 2008 - about 17 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 1750545596 NPPES
Utah MEDICAID 529949454073
Utah MEDICAID 998877666002
Utah MEDICAID 876000308011

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