Jessica Jane Sullivan, PA-C
Physician Assistant in Nutley, NJ. Individual provider (NPI-1).
NPI number1982187142
StatusActive
Last updated in NPPESSep 12, 2018
Details
- NPI
- 1982187142
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jessica Jane Sullivan
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 12, 2018
- Last updated
- Sep 12, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 25MP00486200 | NJ | Yes |
Practice location
115 Franklin AveNutley, NJ 07110-2924
Phone 973-773-9250
Mailing address
23 W ParkwayPequannock, NJ 07440-1709
Phone 973-452-1290
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All 23 Physician Assistant providers in Nutley · All 713 providers in Nutley
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