Provider Demographics
NPI:1497508915
Name:SULLIVAN, HALEY ANN (RN)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:ANN
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1677 54TH AVE N APT 121
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-1447
Mailing Address - Country:US
Mailing Address - Phone:334-303-6156
Mailing Address - Fax:
Practice Address - Street 1:719 THOMPSON LN STE 22200
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-4648
Practice Address - Country:US
Practice Address - Phone:615-322-4311
Practice Address - Fax:615-322-9089
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9550428163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse