KELLY E SULLIVAN (NPI# 1144832205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144832205 |
| Entity Type | Individual |
| Full Name | KELLY E SULLIVAN |
| Credential | CRNP |
| Practice Address |
10020 Southern Maryland Blvd Ste 202 Dunkirk MD 20754-3055 |
| Practice Telephone | 2024667546 |
| Mailing Telephone | 2024667546 |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2020-08-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R145166 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124670724 | Kelly Elizabeth Sullivan | Occupational Therapy Assistant | 12 Deforest Rd, Lansdowne, PA 19050-2109 | 2019-07-12 |
| 1427549088 | Kelly Elizabeth Sullivan | Nurse Practitioner | 428 Hartford Tpke Ste 207, Vernon, CT 06066-4841 | 2018-05-19 |
| 1134642267 | Kelly Glen Sullivan | Durable Medical Equipment & Medical Supplies | 3345 Seajay Dr, Beavercreek, OH 45430-1365 | 2017-07-20 |
| 1831636778 | Kelly Sullivan | Assistant Behavior Analyst | 273 Powell Cir, Berlin, MD 21811-1185 | 2017-01-30 |
| 1396197521 | Kelly Sullivan | Speech-Language Pathologist | 82 Ridgecrest Dr, Pittsburgh, PA 15235-4548 | 2016-07-12 |
| 1548657851 | Kelly Sullivan | Speech-Language Pathologist | 1021 Wind River Pkwy, Morrisville, NC 27560-8233 | 2015-04-24 |
| 1568867877 | Kelly Sullivan | Speech-Language Pathologist | 14105 Snow Rd, Brookpark, OH 44142-2557 | 2014-10-29 |
| 1053713024 | Kelly Goodrich Sullivan | Physical Therapist | 2035 Gayle Pl, Clearwater, FL 33763-4217 | 2014-09-22 |
| 1730595752 | Kelly Sullivan | Registered Nurse | 8 Jacqueline Ct, Port Jefferson Station, NY 11776-3117 | 2014-07-10 |
| 1467610998 | Kelly G Sullivan | Social Worker | 321 Burncoat St, Worcester, MA 01606-3141 | 2008-05-30 |
| Street Address |
10020 SOUTHERN MARYLAND BLVD STE 202 |
| City | DUNKIRK |
| State | MD |
| Zip Code | 20754-3055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093855819 | Katherine Lambert | Physician Assistant | 10095 Ward Rd, Dunkirk, MD 20754 | 2007-02-08 |
| 1043377963 | Lengade and Zolfaghari LLC | Dentist | 10020 Southern Md Blvd, Ste 201a, Dunkirk, MD 20754 | 2007-01-02 |
| 1346347838 | Maryland Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 10095 Ward Rd Dunkirk Marketplace, Dunkirk, MD 20754 | 2006-09-19 |
| 1043320161 | Kenneth C Kates Jr. | Dentist | 10345 Southern Maryland Blvd, Suite 211, Dunkirk, MD 20754 | 2006-08-30 |
| 1841200813 | Giant of Maryland LLC | Durable Medical Equipment & Medical Supplies | 10790 Town Center Blvd, Dunkirk, MD 20754 | 2006-08-09 |
| 1184691263 | Laura Susana Radesca | Dentist | 2880 Dunkirk Way, Suite 103, Dunkirk, MD 20754 | 2006-03-07 |
| 1568936821 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 10845 Town Center Blvd Ste 101, Dunkirk, MD 20754 | 2019-01-18 |
| 1023328473 | Calvert Family and Cosmetic Dentistry | Dentist | 10365 Southern Maryland Blvd, Dunkirk, MD 20754 | 2010-10-19 |
| 1851417430 | Dennis Michael Cherry | Dentist | 10420 Southern Maryland Blvd, Dunkirk, MD 20754 | 2007-03-22 |
| 1083681191 | Jose Carlos Juambeltz | Dentist | 2880 Dunkirk Way, Suite 103, Dunkirk, MD 20754 | 2006-03-07 |
| Find all providers in zip 20754 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003301862 | Sarah Katkhouda | Nurse Practitioner | 10845 Town Center Blvd Ste 102, Dunkirk, MD 20754-2712 | 2018-06-25 |
| 1982083010 | Medi-wellness of Calvert | Nurse Practitioner | 10339 Southern Maryland Blvd Ste 206, Dunkirk, MD 20754-3018 | 2015-05-21 |
| 1134738750 | Nina Serene Currie | Nurse Practitioner | 319 Central Ave Ste B, Dunkirk, NY 14048-2137 | 2020-07-29 |
| 1972111375 | Frances Evonne Butler | Nurse Practitioner | 319 Central Ave Ste B, Dunkirk, NY 14048-2137 | 2020-07-21 |
| 1447888474 | Tiffany L Nixon | Nurse Practitioner | 1150 S Main St, Dunkirk, IN 47336-9701 | 2020-03-27 |
| 1215576558 | Micah Vincent Rutland | Nurse Practitioner | 529 Central Ave, Dunkirk, NY 14048-2514 | 2020-01-03 |
| 1518448422 | Stewart Whitver | Nurse Practitioner | 319 Central Ave, Dunkirk, NY 14048-2137 | 2018-08-28 |
| 1124520069 | Mandy Jean Boeckman | Nurse Practitioner | 1150 S Main St, Dunkirk, IN 47336-9701 | 2018-03-07 |
| 1255884920 | Tiffany Oates | Nurse Practitioner | 10095 Ward Rd, Dunkirk, MD 20754-2731 | 2016-07-29 |
| 1902213168 | Kristen Marie Siracuse | Nurse Practitioner | 319 Central Ave, Level B, Dunkirk, NY 14048-2137 | 2014-07-18 |
| Find all providers in DUNKIRK | ||||
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| 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.