Provider Demographics
NPI:1861793853
Name:SULLIVAN, PAULA DELANE (CRNP, BC)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:DELANE
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:CRNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 HUFFMAN RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35215-7502
Mailing Address - Country:US
Mailing Address - Phone:205-815-5000
Mailing Address - Fax:205-815-5246
Practice Address - Street 1:1160 HUFFMAN RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35215-7502
Practice Address - Country:US
Practice Address - Phone:205-815-5000
Practice Address - Fax:205-815-5246
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-050091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily