MRS. DEBORAH LEE SULLIVAN


Address: 211 E Logan St, Suite 105, Caldwell, ID 83605-4882
Phone: 2084540567

MRS. DEBORAH LEE SULLIVAN (NPI# 1093950420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093950420
Entity Type Individual
Full Name MRS. DEBORAH LEE SULLIVAN
Credential ARNP
Practice Address 211 E Logan St
Suite 105
Caldwell
ID 83605-4882
Mailing Address 3706 N Stone Creek Way
Boise
ID 83703-4745
Practice Telephone 2084540567
Practice Fax Number 2084026635
Mailing Telephone 2085143217
Enumeration Date 2008-12-15
Last Update Date 2019-03-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
NP891 ID Physician Assistants & Advanced Practice Nursing Providers

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1487643201 Deborah Ann Sullivan Genetic Counselor, MS 182 Colon Ave, Staten Island, NY 10308-1405 2005-10-14
1023018900 Deborah A Sullivan Nurse Practitioner 2139 N Academy Blvd, Colorado Springs, CO 80909-1507 2005-07-21
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Office Location

Street Address 211 E LOGAN ST
SUITE 105
City CALDWELL
State ID
Zip Code 83605-4882

Providers in the same location

NPI Name Taxonomy Address Enumeration
1073596136 Sean R Weatherston Physical Therapist 211 E Logan St, Suite 101, Caldwell, ID 83605-4835 2005-11-22
1891310892 Sean E Cook Nurse Practitioner 211 E Logan St, Caldwell, ID 83605-4882 2020-06-15
1174973374 David Routt Counselor 211 E Logan St, Suite B3, Caldwell, ID 83605-4882 2016-06-18
1821303504 Nationwide Neuro Health Psychiatry & Neurology 211 E Logan St, Suite 105, Caldwell, ID 83605-4882 2010-08-18
1003073560 Joe Marie Franz Llenos Family Medicine 211 E Logan St, Suite 301, Caldwell, ID 83605-4882 2008-05-21
1154517050 Travis William Palmer Physical Therapist 211 E Logan St, Suite 101, Caldwell, ID 83605-4882 2007-09-24
1710013628 Sharon E. Carswell Family Medicine 211 E Logan St, Suite 303, Caldwell, ID 83605-4882 2007-02-26
1235207937 Brian Richard Trudeau Physical Therapist 211 E Logan St, Suite 101, Caldwell, ID 83605-4882 2006-12-01
1063585305 Idaho Sleep and Neurology Pllc Specialist 211 E Logan St, Suite 105, Caldwell, ID 83605-4882 2006-11-16
1134227945 Wade Harris Psychiatry & Neurology 211 E Logan St, Ste 201, Caldwell, ID 83605-4882 2006-09-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518585660 Laurie Bernstein Occupational Therapist 2205 Sunset Avenue, Caldwell, ID 83605 2020-07-06
1881249316 Elevate Academy Local Education Agency (LEA) 114 W. Chicago St., Caldwell, ID 83605 2019-08-01
1669025359 James Smith Pharmacist 2809 E Caldwell Blvd, Caldwell, ID 83605 2019-07-22
1164910824 Michelle Stoddard Physician Assistant 315 E Elm St Ste 200, Caldwell, ID 83605 2018-04-27
1215430483 Amy E Rudolf Pharmacist 315 E Elm St Ste 150, Caldwell, ID 83605 2018-03-14
1871044883 Kool Ridez LLC Case Management 1803 Ellis Ave., Caldwell, ID 83605 2016-10-14
1932550795 Chris Torgerson Social Worker 3402 Franklin Blvd, Caldwell, ID 83605 2016-06-23
1609237742 Peggy A Mcfarland Counselor 534 Cleveland Suite 230, Caldwell, ID 83605 2016-03-17
1720468101 Devin Douglas Dredge Emergency Medicine 1717 Arlington Ave Dept Of, Caldwell, ID 83605 2015-06-01
1578950168 Trinidad Bridge Licensed Practical Nurse 2909 S. 10th Avenue, Caldwell, ID 83605 2015-04-21
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

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1558986521 Lisa Kay Stimpson Nurse Practitioner 1605 Poen Rd, Kuna, ID 83634-1743 2020-06-15
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1295372308 Elizabeth Balleweg Nurse Practitioner 2306 N 31st St, Boise, ID 83703-5628 2019-12-09
1891264545 Tina Monique Bossolono-williams Nurse Practitioner 1385 Parkview Dr Ste 101, Twin Falls, ID 83301-4084 2018-11-23
1821525452 Kristin Meshelle Hofmann Nurse Practitioner 420 W Main St Ste 206, Boise, ID 83702-7363 2017-05-14
1992237648 Candice Elaine Adams Nurse Practitioner 5108 N Maidstone Way, Boise, ID 83713-1367 2017-03-31
1851832695 Penny Rea Nurse Practitioner 5307 Green Valley Pl, Nampa, ID 83686-5790 2017-03-13
1891176798 Christine Cooper Nurse Practitioner 35 W Idaho St, Weiser, ID 83672 2015-06-16
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Competitor

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City CALDWELL
Zip Code 83605

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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