Provider Demographics
NPI:1033481171
Name:PULLINS, SUNNY LEANN (LPN)
Entity Type:Individual
Prefix:
First Name:SUNNY
Middle Name:LEANN
Last Name:PULLINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 S WASHINGTON ST
Mailing Address - Street 2:PO BOX 501
Mailing Address - City:SAINT PARIS
Mailing Address - State:OH
Mailing Address - Zip Code:43072-9784
Mailing Address - Country:US
Mailing Address - Phone:937-215-4268
Mailing Address - Fax:
Practice Address - Street 1:411 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SAINT PARIS
Practice Address - State:OH
Practice Address - Zip Code:43072-9784
Practice Address - Country:US
Practice Address - Phone:937-215-4268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN123181164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse