National Provider Identifier
Kristine Sullivan, NP
Kristine Sullivan, NP is listed in the NPPES registry with a primary specialty of Nurse Practitioner in Ithaca, NY and a listed phone number of (607) 274-4011.
Profile Overview
- NPI
- 1336799899
- Provider Type
- Individual
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- September 17, 2019
- Last Updated
- September 21, 2021
Practice Location
- 101 Dates Dr
- Ithaca, NY 14850-1342
Phone: (607) 274-4011
Specialties
- Nurse Practitioner (363L00000X)
- Family Nurse Practitioner (363LF0000X)
Full Record
- NPI
- 1336799899
- Entity Type
- Individual
- Last Name
- Sullivan
- First Name
- Kristine
- Name Prefix
- Mrs.
- Credential
- NP
- Mailing Street Address
- 101 Dates Dr
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1342
- Mailing Country
- US
- Practice Street Address
- 101 Dates Dr
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1342
- Practice Country
- US
- Practice Phone
- (607) 274-4011
- Enumeration Date
- September 17, 2019
- Last Updated
- September 21, 2021
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- September 21, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Nurse Practitioner (363L00000X), Family Nurse Practitioner (363LF0000X)