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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JENNA LELSEY SULLIVAN, OD

Active Sole Proprietor

DR. JENNA LELSEY SULLIVAN, OD is a Optometrist healthcare provider located in KAUKAUNA, Wisconsin. NPI 1366936932 is currently active in the NPPES registry. Verify at CMS.

Optometrist · KAUKAUNA, WI

Registration Details

NPI Number
1366936932
Provider Type
Individual
Gender
Female
NPI Issued
Jun 18, 2018 (8.1485998084183 yrs)
Last Updated
Jul 2, 2019
Licenses
3564-35 (WI)
OPC5544 (FL)
Sole Proprietor
Yes

Practice Information

Address
1 BANK AVE
KAUKAUNA, WI, 541302581
Browse WI providers · Browse ZIP 54130
Phone
9207662481
Primary Specialty
Optometrist
152W00000X
Additional Specialty
Optometrist

Other Optometrist Providers in KAUKAUNA, WI

Name Credential NPI
DR. MARK ARTHUR EBBEN OD OPTOMETRIST 1255389201
DAVID G VANDERLOOP II O.D. 1851344642
DR. MARY KATHRYN SCHROEDER OD 1730602467
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.