Laverne A Sullivan, RD

NPI #1023045200 in Fort Wayne, Indiana

Provider Information

NPI Number: 1023045200
Entity Type: Individual
Name: Laverne A Sullivan, RD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dietitian, Registered
Credential: RD
Enumeration Date: Jun 26, 2006
Last Updated: Jul 1, 2014

Practice Location

Address: 4210 FLAGSTAFF CV
City: Fort Wayne
State: Indiana
ZIP Code: 46815-4417
Phone: (260) 489-9009

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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