Provider Demographics
NPI:1235227539
Name:SULLIVAN, MARGARET G (NP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:G
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 HAYES AVE
Mailing Address - Street 2:BLDG. A
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-7248
Mailing Address - Country:US
Mailing Address - Phone:419-626-6161
Mailing Address - Fax:419-626-7030
Practice Address - Street 1:1326 E PERKINS AVE
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-5025
Practice Address - Country:US
Practice Address - Phone:419-625-5065
Practice Address - Fax:419-621-1276
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP09095363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2703739Medicaid
OHNP09095OtherCERTIFIED NURSE PRACTITIO
OHRN265442OtherREGISTERED NURSE 1
OHRN265442OtherREGISTERED NURSE 1
OHQ72776Medicare UPIN
OHNP09095OtherCERTIFIED NURSE PRACTITIO