Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CRISTIANNA F SULLIVAN, MD
Active Sole ProprietorPediatric Nutrition · SALMON, ID
Registration Details
- NPI Number
- 1336906528
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 4, 2024 (2.1341524221466 yrs)
- Last Updated
- Mar 4, 2024
- License
-
C2813089 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
25 HOKANSON LN UPPR GRANDESALMON, ID, 834675114Browse ID providers · Browse ZIP 83467
- Phone
- 2084874839
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.