Sullivan, Travis J

Sullivan, Travis J is an individual health care provider with primary practice located at 8901 W Lincoln Ave , West Allis WI 53227-2409. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Sullivan, Travis J can be contacted via phone (414) 328-6000.

Contact Information

Primary practice address
8901 W Lincoln Ave West Allis WI 53227-2409
Phone: (414) 328-6000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 160832-30 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 5084 Wisconsin

Profile Details

NPI number 1881950350
LBN Legal business name Sullivan, Travis J
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2012
Last updated Oct 23rd, 2023 - about last year

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 1881950350 NPPES
Wisconsin MEDICAID 100023698

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