Sullivan, Jillian Ann

Sullivan, Jillian Ann is an individual health care provider with primary practice located at 263 Farmington Ave Internal Medicine, Farmington CT 06030-2212. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Sullivan, Jillian Ann can be contacted via phone (860) 679-4477.

Contact Information

Primary practice address
263 Farmington Ave Internal Medicine Farmington CT 06030-2212
Phone: (860) 679-4477
Fax: (860) 679-4474
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 005128 Connecticut

Profile Details

NPI number 1639423734
LBN Legal business name Sullivan, Jillian Ann
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 29th, 2012
Last updated Feb 5th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639423734 NPPES
Connecticut MEDICAID 1639423734

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