Sullivan, Sandra
Sullivan, Sandra is an individual health care provider with primary practice located at 6700 W Overland Rd , Boise ID 83709-2032. She recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as her primary health care specialty. Sullivan, Sandra can be contacted via phone (208) 319-4587.Contact Information
Primary practice address
6700 W Overland Rd
Boise ID 83709-2032
Phone: (208) 319-4587
Fax: (208) 377-3883
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Related Providers / Personal Care Attendant | 3747P1801X |
Profile Details
| NPI number | 1568127124 |
|---|---|
| LBN Legal business name | Sullivan, Sandra |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 8th, 2021 |
| Last updated | Nov 8th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568127124 | NPPES |
| Idaho | MEDICAID | A0000141 |
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