NPI 1245538669

Kevin John Sullivan, CRNA

Practitioner Certified Registered Nurse Anesthetist Tamuning, GU

Practice location

Address: 280 Pale San Vitores Rd, Tamuning, GU 96913-3615
Phone: (671) 647-4542
Mailing address: 369 Farenholt Ave, Tamuning, GU 96913-3106

Registered specialties (3)

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence NP0152 (GU)

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Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence CRNA000407 (NV)

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Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence ARNP9237910 (FL)

Registry record

NPI: 1245538669
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Mar 2011
Record last updated: 12 Mar 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.