IndividualActive
Kandis Sullivan
NPI 1861714917 · Primary Care Nurse Practitioner · Tomah, WI
Provider details
- NPI number
- 1861714917
- Entity type
- Individual
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 108168-030 (WI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Nursing Service Providers
Practice location
500 E Veterans St
Tomah, WI 54660-3105
Phone: (608) 372-3971
Approximate (ZIP-level) locationGet directions
Mailing address
1904 Cedar Creek Dr
Rothschild, WI 54474-1461
Registry dates
- Enumerated
- 2010-02-17
- Last updated
- 2016-07-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.