Provider Demographics
NPI:1609365857
Name:SULLIVAN, JANELLE CROZIER (MD)
Entity Type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:CROZIER
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:NICHOLE
Other - Last Name:CROZIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2702 NAVARRE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3224
Mailing Address - Country:US
Mailing Address - Phone:419-697-6777
Mailing Address - Fax:419-697-6712
Practice Address - Street 1:3900 SUNFOREST CT STE 215
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4440
Practice Address - Country:US
Practice Address - Phone:419-473-6670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.141032208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics