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Nanako Shannon Sullivan, PA
Student in an Organized Health Care Education/Training Program in Longmeadow, Massachusetts
NPI 1871277780

Nanako Shannon Sullivan is a Student in an Organized Health Care Education/Training Program based in Longmeadow, MA. Nanako Shannon Sullivan practices in Longmeadow, MA and has the professional credentials of PA. The NPI Number for Nanako Shannon Sullivan is 1871277780 and holds a License No. (Massachusetts).

The current practice location address for Nanako Shannon Sullivan is 588 Longmeadow St, Longmeadow, MA and can be reached out via phone at 800-782-7284.

Location: 588 Longmeadow St, Longmeadow, MA, 01106-2292
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871277780
Provider Name
Nanako Shannon Sullivan
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
588 Longmeadow St, Longmeadow, MA, 01106-2292
Phone Number
800-782-7284
Fax Number
Provider Enumeration Date
06/12/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
588 Longmeadow St
City
Longmeadow
State
Massachusetts
Zip
01106-2292
Phone Number
800-782-7284
Fax Number
person
Provider Business Mailing Address Details
Address
588 Longmeadow St
City
Longmeadow
State
Massachusetts
Zip
01106-2292
Phone Number
800-782-7284
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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