MOLLY SULLIVAN (NPI# 1265983316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265983316 |
| Entity Type | Individual |
| Full Name | MOLLY SULLIVAN |
| Practice Address |
350 W Woodrow Wilson Ave Jackson MS 39213-7681 |
| Mailing Address |
2500 N State St Jackson MS 39216-4500 |
| Practice Telephone | 6018150157 |
| Practice Fax Number | 6019845257 |
| Mailing Telephone | 6018150157 |
| Mailing Fax Number | 6019845257 |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2016-12-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
901715 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 04950045 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275162554 | Molly Sullivan | Student in an Organized Health Care Education/Training Program | 3930 The Vanderbilt Clinic 1301 Medical Center Drive, Nashville, TN 37232-0001 | 2020-04-07 |
| 1457919037 | Molly Breck Sullivan | Counselor | 982 Mission St, San Francisco, CA 94103-2911 | 2019-05-30 |
| 1306409990 | Molly Sullivan | Physical Therapist | 8737 Colesville Rd, Silver Spring, MD 20910-3928 | 2019-04-18 |
| 1366980815 | Molly Ambler Sullivan | Nurse Practitioner | 110 Irving St Nw, Washington, DC 20010-3017 | 2017-02-05 |
| 1841413283 | Molly Sullivan | Psychologist | 1600 Shattuck Ave, #200, Berkeley, CA 94709-1634 | 2007-04-11 |
| 1679679906 | Molly Ann Sullivan | Radiology | 27 Park St, Cape Cod Hospital/radiation Oncology Dept., Hyannis, MA 02601-5230 | 2006-09-15 |
| Street Address |
350 W WOODROW WILSON AVE |
| City | JACKSON |
| State | MS |
| Zip Code | 39213-7681 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184607210 | Srinivasan Vijayakumar | Radiology | 350 W Woodrow Wilson Ave, Suite 16, Jackson, MS 39213-7681 | 2005-11-22 |
| 1487285268 | Andreina Guedez Mijares | Dietitian, Registered | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2020-01-30 |
| 1114492725 | Kandis Vechelle Backus | Pharmacist | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2018-10-10 |
| 1780104646 | Jamie Simonson Dean | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2017-06-22 |
| 1730610775 | Take Care Pharmacy | Pharmacy | 350 W Woodrow Wilson Ave, Suite 311, Jackson, MS 39213-7681 | 2017-03-22 |
| 1891236725 | Christina Purviance | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2017-03-11 |
| 1982057345 | Flora K. Green | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2016-07-20 |
| 1619346822 | Shundra Wilson | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2015-09-17 |
| 1336521343 | Karen Cathey | Counselor | 350 W Woodrow Wilson Ave, Suite 3572, Jackson, MS 39213-7681 | 2015-06-25 |
| 1255721080 | Medhome Specialty Services, LLC | Durable Medical Equipment & Medical Supplies | 350 W Woodrow Wilson Ave, Suite 241, Jackson, MS 39213-7681 | 2015-02-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679117980 | Cynthia Bailey | Technician | 916 Carnation Street, Jackson, MS 39213 | 2019-10-30 |
| 1871136374 | Shirley Collins Williams | Technician | 3132 Sage St, Jackson, MS 39213 | 2019-10-28 |
| 1275057069 | Nikita Patel | Pharmacist | 830 West Woodrow Wilson Avenue, Jackson, MS 39213 | 2017-08-02 |
| 1346782893 | Mississippi Smiles Dentistry LLC | Dentist | 310 W Woodrow Wilson Ave, 400, Jackson, MS 39213 | 2016-11-15 |
| 1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
| 1518410778 | Assurance Home Health Services, LLC | Health Maintenance Organization | 1771 Hamilton Blvd., Jackson, MS 39213 | 2016-07-25 |
| 1831576180 | Dorothy Jeffries Anderson | Counselor | 350 Woodrow Wilson Ave, Jackson, MS 39213 | 2015-05-06 |
| 1740697275 | Sincere Home Care LLC. | Chore Provider | 5911 Holmes Ct, Jackson, MS 39213 | 2014-07-16 |
| 1629401088 | Deborah Diane Wright | Assisted Living Facility | 5911 Holmes Court, Jackson, MS 39213 | 2013-08-20 |
| 1245663251 | Methodist Home Road Living Center | Licensed Practical Nurse | 4560 Methodist Home Road, Jackson, MS 39213 | 2013-08-13 |
| Find all providers in zip 39213 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113627 | Jessicah Blasdel | Nurse Practitioner | 113 W Michigan Ave, Jackson, MI 49201-1340 | 2020-10-31 |
| 1801406335 | Jade Russell | Nurse Practitioner | 2205 W Morrell St, Jackson, MI 49203-1357 | 2020-08-10 |
| 1992315212 | Patrecia Campbell | Nurse Practitioner | 2570 Bailey Ave Ste 7, Jackson, MS 39213-6905 | 2020-08-01 |
| 1669008926 | Kristine Edwards | Nurse Practitioner | 723 Woodlawn Ave, Jackson, MI 49203-2921 | 2020-03-19 |
| 1295366391 | Christy White | Nurse Practitioner | 363 Old Pinson Rd, Jackson, TN 38301-9576 | 2020-01-28 |
| 1972141620 | Primary Care - Bemis, LLC | Nurse Practitioner | 1385 S Highland Ave Ste B4, Jackson, TN 38301-7547 | 2019-12-12 |
| 1174164263 | Tami Anne Miller | Nurse Practitioner | 124 N Bast St, Jackson, MO 63755-1704 | 2019-10-01 |
| 1265080584 | Cameron Nicole Howard | Nurse Practitioner | 1860 Chadwick Dr Ste 256, Jackson, MS 39204-3486 | 2019-08-29 |
| 1831750843 | Rhiannon Michelle Andresen | Nurse Practitioner | 1022 Greystone Sq, Jackson, TN 38305-3580 | 2019-06-21 |
| 1902376361 | Jenay B Krumm | Nurse Practitioner | 1201 E Michigan Ave Ste 200, Jackson, MI 49201-1855 | 2018-11-28 |
| Find all providers in JACKSON | ||||
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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.