Provider Demographics
NPI:1841896073
Name:SULLIVAN, CHRISTINE (DOULA)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5356 CHEW AVE BLDG B
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19138-2804
Mailing Address - Country:US
Mailing Address - Phone:215-929-6200
Mailing Address - Fax:
Practice Address - Street 1:5356 CHEW AVE BLDG B
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-2804
Practice Address - Country:US
Practice Address - Phone:215-929-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula