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Kelly Sullivan
Family Nurse Practitioner in Bridgeport, Connecticut
NPI 1154590651

Kelly Sullivan is a Family Nurse Practitioner based in Wilton, CT and is specialized in Family. Kelly Sullivan practices in Bridgeport, CT. The NPI Number for Kelly Sullivan is 1154590651 and holds a License No. 002446 (Connecticut).

The current practice location address for Kelly Sullivan is 275 George St, Bridgeport, CT and can be reached out via phone at 203-576-8462.

Location: 275 George St, Bridgeport, CT, 06897-1110
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1154590651
Provider Name
Kelly Sullivan
Credential
Provider Entity Type
Individual
Gender
Female
Address
275 George St, Bridgeport, CT, 06897-1110
Phone Number
203-576-8462
Fax Number
Provider Enumeration Date
02/28/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
002446 01 CT LICENSE
institution
Provider Business Practice Location Address Details
Address
275 George St
City
Bridgeport
State
Connecticut
Zip
06604-3320
Phone Number
203-576-8462
Fax Number
person
Provider Business Mailing Address Details
Address
275 George St
City
Bridgeport
State
Connecticut
Zip
06604-3320
Phone Number
203-576-8462
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
002446 (Connecticut)
Definition
Definition to come...
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