Provider Demographics
NPI:1720563208
Name:SULLIVAN, KARI LYN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KARI
Middle Name:LYN
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3854 COTTAGE GROVE CT
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-9529
Mailing Address - Country:US
Mailing Address - Phone:989-928-2932
Mailing Address - Fax:
Practice Address - Street 1:926 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-4369
Practice Address - Country:US
Practice Address - Phone:989-753-8453
Practice Address - Fax:989-753-3519
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704281889363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily