MARYELLEN SULLIVAN (NPI# 1306812086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306812086 |
| Entity Type | Individual |
| Full Name | MARYELLEN SULLIVAN |
| Credential | NP |
| Practice Address |
950 Winter Street Waltham MA 02451 |
| Mailing Address |
1200 Centre St Dept. of Medicine Roslindale MA 02131-1011 |
| Practice Telephone | 7814728787 |
| Mailing Telephone | 6173638010 |
| Mailing Fax Number | 6173638929 |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2015-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
142612 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518027333 | Maryellen Sullivan | Physical Therapist | 32672 Us 19 N, Palm Harbor, FL 34684 | 2006-12-11 |
| Street Address |
950 WINTER STREET |
| City | WALTHAM |
| State | MA |
| Zip Code | 02451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821307398 | Caroline Tafadzwa Tigere | Nurse Practitioner | 950 Winter Street, Waltham, MA 02451 | 2010-10-01 |
| 1952453193 | Pamela Morris-wilgren | Nurse Practitioner | 950 Winter Street, Suite 3800, Waltham, MA 02451 | 2007-01-17 |
| 1841340833 | Karen A Tepper | Nurse Practitioner | 950 Winter Street, Evercare, Waltham, MA 02451 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719190 | Haeun Yang | Behavior Technician | 303 Wyman Street Suite 354, 344, 345, Waltham, MA 02451 | 2019-09-16 |
| 1982252599 | Sinclair Fashaw-braxton | Behavior Technician | 303 Wyman Street, Suite 354, 344, 345, Waltham, MA 02451 | 2019-08-27 |
| 1245715879 | Annie F Friedman | Social Worker | Extended Stay America, 32 4the Avenue, Waltham, MA 02451 | 2018-09-28 |
| 1760964118 | Elizabeth Boardman Harris | Social Worker | 60 Hickory Drive 4th Floor, Waltham, MA 02451 | 2018-09-02 |
| 1760960959 | Patriot Urgent Care Professionals, PC | General Practice | 1030 Main Street, Unit 2, Waltham, MA 02451 | 2018-07-31 |
| 1962998013 | Leighann Teresa Healy | Behavior Technician | 303 Wyman Suite 300, Waltham, MA 02451 | 2018-07-02 |
| 1194234492 | Bruna Rossi Hoffman | Dentist | 12 Grant Place, Apt 1, Waltham, MA 02451 | 2017-09-29 |
| 1265959159 | Matthew C Page-shelton | Counselor | 2208 Stearns Hill Road, Waltham, MA 02451 | 2017-08-23 |
| 1306380837 | Sherri Lynn Duquette | Behavior Technician | 1430 Main Street, Waltham, MA 02451 | 2016-12-19 |
| 1649628728 | Keren Matveev | Family Medicine | 75 Third Avenue, First Floor, Waltham, MA 02451 | 2016-05-30 |
| Find all providers in zip 02451 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831414416 | Stephen M Bolio | Nurse Practitioner | 72a Charles River Rd, Waltham, MA 02453-2402 | 2010-04-07 |
| 1477744787 | Marygrace Davie Barber | Nurse Practitioner | Bentley College, 175 Forest St, Waltham, MA 02452-4705 | 2007-08-05 |
| 1548327638 | Kerry Lynn Kilroy | Nurse Practitioner | 950 Winter St Ste 3800, Waltham, MA 02451-1487 | 2007-01-02 |
| 1144695867 | Janice Allen | Nurse Practitioner | 870 Winter St, Waltham, MA 02451-1449 | 2015-12-07 |
| 1962870220 | Elizabeth S Duffy | Nurse Practitioner | 950 Winter St, 4th Floor, Waltham, MA 02451-1424 | 2015-09-03 |
| 1760866065 | Partners Home Care Inc | Nurse Practitioner | 281 Winter St, Suite 240, Waltham, MA 02451-8740 | 2015-07-16 |
| 1457743064 | Leslie Jane Cadigan | Nurse Practitioner | 415 South St # Ms 034, Waltham, MA 02453-2728 | 2015-02-19 |
| 1669862736 | Catherine Camacho | Nurse Practitioner | 950 Winter St, 3800, Waltham, MA 02451-1424 | 2015-01-28 |
| 1093141798 | Denise Christine Kelley | Nurse Practitioner | 950 Winter St, Suite 2200/3800, Waltham, MA 02451-1227 | 2013-09-25 |
| 1750643706 | Sarah Stollar Smith | Nurse Practitioner | 85 1st Ave, Waltham, MA 02451-1105 | 2012-06-14 |
| Find all providers in WALTHAM | ||||
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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.