Provider Demographics
NPI:1326261835
Name:SULLIVAN, ELEANOR COCHRANE (CPNP)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:COCHRANE
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:PATTIE
Other - Middle Name:
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPNP
Mailing Address - Street 1:1100 LAKE HEARN DR NE STE 100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1524
Mailing Address - Country:US
Mailing Address - Phone:404-256-3178
Mailing Address - Fax:404-256-3583
Practice Address - Street 1:1100 LAKE HEARN DR NE
Practice Address - Street 2:STE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1523
Practice Address - Country:US
Practice Address - Phone:404-256-3178
Practice Address - Fax:404-256-3583
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN073627NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics