Provider Demographics
NPI:1265549851
Name:SULLIVAN, BOBBIE C (CRNP, FNP)
Entity type:Individual
Prefix:
First Name:BOBBIE
Middle Name:C
Last Name:SULLIVAN
Suffix:
Gender:
Credentials:CRNP, FNP
Other - Prefix:
Other - First Name:BOBBIE
Other - Middle Name:SULLIVAN
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3909 MCFARLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-2838
Mailing Address - Country:US
Mailing Address - Phone:205-333-1993
Mailing Address - Fax:205-333-0293
Practice Address - Street 1:3909 MCFARLAND BLVD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-2838
Practice Address - Country:US
Practice Address - Phone:205-333-1993
Practice Address - Fax:205-333-0293
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-058971363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner