ANNA NICOLE POWELL SULLIVAN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085010467

License Status

ACTIVE

Business

First Name

ANNA

Middle

NICOLE POWELL

Last Name

SULLIVAN

Business Name

ANNA NICOLE POWELL SULLIVAN

Original Issue Date

06/05/2024

Effective Date

01/22/2026

Expiration Date

03/01/2028

City

DURHAM

State

Zip

27703

Ever Disciplined

LastModifiedDate

01/22/2026