MISS THEA DELORA SULLIVAN RN NPI 1356584379

NPI Information

NPI: 1356584379
Provider Name: MISS THEA DELORA SULLIVAN, RN
Classification: Registered Nurse - 163WP2201X
Entity Type: Individual

Specialization: Ambulatory Care

Address:
3628 RIVER HEIGHTS XING SE
MARIETTA, GA
ZIP 30067
Phone: (770) 272-0716
Get Directions

MISS Thea Delora Sullivan, RN is an ambulatory care registered nurse in Marietta, GA. MISS Thea Delora Sullivan, RN NPI is 1356584379. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3628 RIVER HEIGHTS XING SE
MARIETTA, GA
ZIP 30067-870
Phone: (770) 272-0716

The enumeration date for this NPI number is 4/7/2009 and was last updated on 4/7/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WP2201X	Registered Nurse	Ambulatory Care	RN196107	GEORGIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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