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Contact Information

JACQUELINE Y SULLIVAN, CNM
1165 IMPERIAL DR STE 200
HAGERSTOWN, MD21740-6583
 Phone: 301-665-9098
 Fax: 301-665-9096
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Advanced Practice Midwife

367A00000X 42 Certified Nurse Midwife
Indicates primary specialty

NPI Profile & details for JACQUELINE Y SULLIVAN · (Female)

NPI Number 1679847107
Status Active
Credentials CNM (Certified Nurse Midwife)
Entity Individual
Enumeration date 03/01/2012
Last updated 12/01/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • PA License # MW010272
  • PA Medicaid 102733511
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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