Sullivan, Lorraine Louise

Sullivan, Lorraine Louise is an individual health care provider with primary practice located at 1577 Congress St 1St Floor, Portland ME 04102-2169. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Sullivan, Lorraine Louise can be contacted via phone (207) 662-1442.

Contact Information

Primary practice address
1577 Congress St 1St Floor Portland ME 04102-2169
Phone: (207) 662-1442
Fax: (207) 775-2467
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X R016719 Maine
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X CNP81643 Maine

Profile Details

NPI number 1467548578
LBN Legal business name Sullivan, Lorraine Louise
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Dec 1st, 2014 - about 11 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 1467548578 NPPES
Maine MEDICAID 263670099

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