Most Relevant Information
Provider Data
| NPI Number: | 1003497801 |
| Provider Name: | KEVIN SULLIVAN |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/14/2021 |
| Last Updated: | 04/14/2021 |
Provider Practice Location
2102 S LOPEZ ST
NEW ORLEANS
LA
701254438
Practice Location Phone/Fax
| Phone: | 6784588917 |
| Fax: |
Provider Mailing Location
2102 S LOPEZ ST
NEW ORLEANS
LA
701254438
Provider Mailing Phone/Fax
| Phone: | 6784588917 |
| Fax: |