Stayce K Sullivan
Stayce K Sullivan is a Nurse Practitioner in San Rafael, California. Qualified in 2018, 8 years ago. Practices with Omar Osman Practice, LLC, a 43-clinician group and accepts Medicare assignment. Licensed in California.
- Years since qualifying
- 8
- Licensed in
- CA
- In the registry since
- 2019
Practice location Address checks out
515 Northgate Dr Ste 101San Rafael, CA 94903-9490
Phone: (415) 202-9990
Fax: (415) 202-0102
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Acute Care Nurse Practitioner (primary) | Taxonomy 363LA2100X · Licence 95012073 (CA) |
|---|
Record details
| NPI number | 1770139123 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | August 12, 2019 |
| Last updated in NPPES | August 12, 2019 |
| Mailing address | 42 Grande Paseo, San Rafael, CA 94903-1546 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2018 (8 years in practice) |
| Group practice | Omar Osman Practice, Llc — 43 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in San Rafael
-
Lance Benedict, NP
99 Montecillo Rd, San Rafael, CA 94903-3308 · (415) 444-4927