Patricia A Sullens, MEDICAL ASSIT

Individual provider Active NPI Nutrition Education Nutritionist · Baldwin, GA

NPI 1154536613 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154536613
Entity type
Individual (NPI type 1)
Primary specialty
Nutrition Education Nutritionist 133NN1002X
Practice address
441 Professional Complex
Suite 479D
Baldwin, GA 30511
Phone
(706) 778-0033
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X Yes

Addresses

Primary practice location

441 Professional Complex
Suite 479D
Baldwin, GA 30511

Mailing address

441 Professional Complex
Suite 479D
Baldwin, GA 30511
Phone (706) 778-0033

Other providers in Baldwin, GA

All providers in Baldwin, GA · Nutrition Education Nutritionist in Georgia

Sources for this page

Verify at the official NPI Registry.