Basic Information
| Provider Information | |||||||||
| NPI: | 1023239894 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SULLIVAN | ||||||||
| FirstName: | HEMELINA | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 302 | ||||||||
| Address2: | 602 WEST COLORADO | ||||||||
| City: | RIO HONDO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78583 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9567925520 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 508 VICTORIA LANE | ||||||||
| Address2: | |||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9564259600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | 436552 | TX | Y | Nursing Service Providers | Registered Nurse | Critical Care Medicine |
No ID Information.