Miya Venetia Sullivan in Saint Louis - Athletic Trainer
Miya Venetia Sullivan - NPI 1649488503
Miya Venetia Sullivan is a Athletic Trainer in Saint Louis, Missouri. Miya Venetia Sullivan practices all healthcare services and medical treatments related to Athletic Trainer. The NPI Number for Miya Venetia Sullivan is 1649488503. The last update date is 2007-07-08.
Miya Venetia Sullivan's current location address is 3672 W Pine Mall Blvd, Saint Louis, Missouri. You can contact this provider via phone number 3149777024. The mailing address for Miya Venetia Sullivan is 3672 W Pine Mall Blvd, Saint Louis, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Miya Venetia Sullivan |
|---|---|
| Address | 3672 W Pine Mall Blvd, Saint Louis, Missouri |
| Phone Number | 3149777024 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | MS, ATC |
NPI Number Detail
| NPI Number | 1649488503 |
|---|---|
| Provider Enumeration Date | 2007-05-21 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3672 W Pine Mall Blvd |
|---|---|
| City | Saint Louis |
| State | Missouri (MO) |
| Post Code | 631083304 |
| Phone Number | 3149777024 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Athletic Trainer |
|---|---|
| Taxonomy | 2255A2300X |
| Licence No | 2000170998 |
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Definition: Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-leve |
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What is the unique 10-digit identifier code assigned to Miya Venetia Sullivan by the Centers for Medicare & Medicaid Services?
The Miya Venetia Sullivan has been issued the NPI (National Provider Identifier) 1649488503 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Miya Venetia Sullivan?
The Miya Venetia Sullivan is physically situated at 3672 W Pine Mall Blvd, in the city of Saint Louis, state of MO, with the postal code 631083304.
What is Miya Venetia Sullivan's area of expertise and its corresponding taxonomy classification?
The Miya Venetia Sullivan's field of specialization is Athletic Trainer, and it falls under the taxonomy code 2255A2300X, which categorizes healthcare providers based on their areas of practice.
On what date did Miya Venetia Sullivan receive its 1649488503 assignment from the Centers for Medicare & Medicaid Services?
The Miya Venetia Sullivan was assigned its 1649488503 on 2007-05-21, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Miya Venetia Sullivan most recently updated?
The details pertaining to the Miya Venetia Sullivan, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.
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