Sullivan, Stephanie M.
Sullivan, Stephanie M. is an individual health care provider with primary practice located at 2001 Dwight Way Second Floor, Berkeley CA 94704-2608. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, which is considered as her primary health care specialty. Sullivan, Stephanie M. can be contacted via phone (510) 204-5770.Contact Information
Primary practice address
2001 Dwight Way Second Floor
Berkeley CA 94704-2608
Phone: (510) 204-5770
Fax: (510) 204-5749
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology | 363LX0001X | 566514 | California |
Profile Details
NPI number | 1730121864 |
---|---|
LBN Legal business name | Sullivan, Stephanie M. |
Credentials | MSN, NP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 12th, 2006 |
Last updated | Jan 11th, 2022 - about 3 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 | 1730121864 | NPPES |
California | MEDICAID | 005665140 |
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