Jennifer Mae Sullivan
Nurse Practitioner - Women's Health
500 Osborne Rd Ne Suite 200
Fridley
, Minnesota 55432-2774
Jennifer Mae Sullivan
Nurse Practitioner - Women's Health
500 Osborne Rd Ne Suite 200
Fridley
, Minnesota 55432-2774
(612) 262-5000
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About
Features
Specialties
- Nurse Practitioner - Women's Health
Languages spoken
- English
Location
First Address
- Jennifer Mae Sullivan
- 2925 Chicago Ave
- Minneapolis, MN
- Zip : 55407-1321
- Phone : (612) 262-5000
Second Address
- Jennifer Mae Sullivan
- 500 Osborne Rd Ne Suite 200
- Fridley, MN
- Zip : 55432-2774
- Phone : (763) 786-6011
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LW0102X | Nurse Practitioner - Women's Health | R1564338 | MN |
National Provider Identifier
| NPI | 1053584789 |
|---|---|
| Provider Name | Jennifer Mae Sullivan |
| First Address | Minneapolis, MN 55407-1321 |
| Second Address | Fridley, MN 55432-2774 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/04/2008 |
| Last Update Date | 10/11/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.