Individual provider · NPI-1

Jillian C Sullivan

Community Health Worker · Wilmington, DE

NPI number1669969549
StatusActive
Last updated in NPPESApr 17, 2018

Details

NPI
1669969549
Entity type
Individual (NPI-1)
Name
Jillian C Sullivan
Sex
Female
Sole proprietor
No
Enumeration date
Apr 17, 2018
Last updated
Apr 17, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172V00000X Community Health Worker––Yes

Practice location

3506 Kennett Pike
Wilmington, DE 19807-3019

Phone 302-661-3043

Mailing address

200 Hygeia Dr Ste 2300
Newark, DE 19713-2049

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