Provider Demographics
NPI:1932742400
Name:SULLIVAN, CHRISTINA (DNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:FROEHLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:774 POLVADERA ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-3951
Mailing Address - Country:US
Mailing Address - Phone:952-836-9608
Mailing Address - Fax:
Practice Address - Street 1:774 POLVADERA ST
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-3951
Practice Address - Country:US
Practice Address - Phone:952-836-9608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2025-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR217955363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health