KATHLEEN M. SULLIVAN (NPI# 1306095955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306095955 |
| Entity Type | Individual |
| Full Name | KATHLEEN M. SULLIVAN |
| Credential | APRN |
| Practice Address |
20511 Sunset Ln Lago Vista TX 78645-6245 |
| Practice Telephone | 8604601211 |
| Practice Fax Number | 8607606113 |
| Mailing Telephone | 8604601211 |
| Mailing Fax Number | 8604601211 |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2018-09-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
NPP37789 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265890909 | Kathleen Sullivan | Clinical Nurse Specialist | 2040 9th Ave, # C, Honolulu, HI 96816-2952 | 2016-02-09 |
| 1871907006 | Kathleen E Sullivan | Behavioral Analyst | 118 35th St, Bellingham, WA 98225-6053 | 2014-06-16 |
| 1285057687 | Kathleen Sullivan | Registered Nurse | 2380 Timbercrest Cir W, Clearwater, FL 33763-1624 | 2014-01-22 |
| 1538436555 | Kathleen Sullivan | Speech-Language Pathologist | 301 Charlotte Ave, Hamburg, NY 14075-3857 | 2011-11-18 |
| 1396023388 | Kathleen T Sullivan | Occupational Therapist | 6678 County Road 32, Norwich, NY 13815-3554 | 2011-07-26 |
| 1912204322 | Kathleen Ann Sullivan | Speech-Language Pathologist | 3043 State Route 48, Oswego, NY 13126-5733 | 2011-02-21 |
| 1790938694 | Kathleen Scarlett Sullivan | Marriage & Family Therapist | 3851 Rosecrans St Ste K-08, San Diego, CA 92110-3115 | 2008-10-23 |
| 1639320336 | Kathleen Connelly Sullivan | Physician Assistant | 2 Fogg Rd, Weymouth, MA 02190 | 2008-10-01 |
| 1356518492 | Kathleen C Sullivan | Licensed Practical Nurse | 340 Vincent St., Syracuse, NY 13210-3712 | 2008-05-08 |
| 1881874758 | Kathleen E Sullivan | Counselor | 12 Beach St, Saco, ME 04072-2802 | 2007-11-08 |
| Street Address |
20511 SUNSET LN |
| City | LAGO VISTA |
| State | TX |
| Zip Code | 78645-6245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730532094 | Carla Frances Hugus Thomas | Dentist | 8008 Bronco Ln, Lago Vista, TX 78645 | 2016-07-21 |
| 1730416181 | Lago Vista Physical Therapy | Physical Therapist | 5802 Thunderbird St., Suite A, Lago Vista, TX 78645 | 2009-11-05 |
| 1992811756 | Carol Marie Ambrosius | Chiropractor | 20811 Dawn Dr, Suite 505, Lago Vista, TX 78645 | 2006-08-22 |
| 1356455265 | Elizabeth S Neal | Family Medicine | 8808 Bronco Lane, Suite 1, Lago Vista, TX 78645 | 2006-08-18 |
| 1639101819 | Rambie Le Briggs | Internal Medicine | 18649 Fm 1431, Ste 12a Jonestown Community Health Center, Jonestown, TX 78645 | 2006-07-07 |
| 1639129562 | Andrea Ellen Cramer | Pediatrics | 1417 Osprey Ridge Loop, Lago Vista, TX 78645 | 2006-05-11 |
| 1801375027 | Shannon Lorraine-konopik Wassel | Nurse Practitioner | 8808 Bronco Lane, Suite 1, Lago Vista, TX 78645 | 2018-08-08 |
| 1902393499 | Lone Star Circle of Care | Clinic/Center | 18220 Fm 1431, Ste D, Jonestown, TX 78645 | 2018-04-19 |
| 1780214346 | Rubye Ramona Moyer | Registered Nurse | 11536 Crumley Creek Rd, Jonestown, TX 78645-3108 | 2020-01-23 |
| 1558526053 | Michael B Tenbrook | Dentist | 18672 Fm 1431, Jonestown, TX 78645-3413 | 2008-07-23 |
| Find all providers in zip 78645 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215537857 | Julius Abam | Nurse Practitioner | 634 Rustic Trl, Midlothian, TX 76065-2267 | 2020-10-30 |
| 1750981619 | Suvekchya Subedi | Nurse Practitioner | 4032 Vista Mar Drive, Euless, TX 76040 | 2020-10-29 |
| 1821698754 | Christienne Felice Solis Callasan | Nurse Practitioner | 1010 Palos Verdes Blvd, Arlington, TX 76017-1780 | 2020-10-29 |
| 1932709201 | Aftercare, Pllc | Nurse Practitioner | 2000 Crawford St Ste 1221, Houston, TX 77002-9000 | 2020-10-27 |
| 1497355929 | Hector Medellin IIi | Nurse Practitioner | 6014 County Road 4068, Kemp, TX 75143-2600 | 2020-10-26 |
| 1639778947 | Aj Psychiatry Pllc | Nurse Practitioner | 1920 N Coit Rd Ste 219, Richardson, TX 75080-2832 | 2020-10-19 |
| 1154929735 | Valerie Michelle Vaughn-smith | Nurse Practitioner | 3105 Rockbrook Dr, Kilgore, TX 75662-2251 | 2020-10-15 |
| 1700483468 | Knd Behavioural Health Clinic | Nurse Practitioner | 103 Herrington Dr, Mansfield, TX 76063-7615 | 2020-10-06 |
| 1184231805 | Tihana Sladic | Nurse Practitioner | 1515 S Capital of Texas Hwy Ste 300&301, Austin, TX 78746-6579 | 2020-09-27 |
| 1679189369 | Charity Chioma Durant | Nurse Practitioner | 2310 Echo Ct, Rowlett, TX 75088-1534 | 2020-09-18 |
| Find all providers with the same taxonomy | ||||
| City | LAGO VISTA |
| Zip Code | 78645 |
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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.