Mary Kathleen Sullivan
Nurse Practitioner - Primary Care
1920 Kirby Pkwy Ste 102
Germantown
, Tennessee 38138-3654
Mary Kathleen Sullivan
Nurse Practitioner - Primary Care
1920 Kirby Pkwy Ste 102
Germantown
, Tennessee 38138-3654
(901) 334-5466
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About
Features
Specialties
- Nurse Practitioner - Primary Care
Languages spoken
- English
Location
First Address
- Mary Kathleen Sullivan
- 1920 Kirby Pkwy Ste 102
- Germantown, TN
- Zip : 38138-3654
- Fax : (901) 334-5466
- Phone : (901) 334-5464
Second Address
- Mary Kathleen Sullivan
- 1920 Kirby Pkwy Ste 102
- Germantown, TN
- Zip : 38138-3654
- Fax : (901) 334-5466
- Phone : (901) 334-5464
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP2300X | Nurse Practitioner - Primary Care | APN 12894 | TN |
National Provider Identifier
| NPI | 1053735282 |
|---|---|
| Provider Name | Mary Kathleen Sullivan |
| First Address | Germantown, TN 38138-3654 |
| Second Address | Germantown, TN 38138-3654 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/02/2014 |
| Last Update Date | 24/09/2015 |
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.