Provider Demographics
NPI:1174340020
Name:SULLIVAN, MARY HELEN (MSN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:HELEN
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:993 JOHNSON FY RD NE BLDG F
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1620
Mailing Address - Country:US
Mailing Address - Phone:404-256-1727
Mailing Address - Fax:404-252-3591
Practice Address - Street 1:993 JOHNSON FY RD NE STE 210
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1620
Practice Address - Country:US
Practice Address - Phone:404-256-1727
Practice Address - Fax:404-252-3591
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN323622363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily