KRISTIN SULLIVAN (NPI# 1417349275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417349275 |
| Entity Type | Individual |
| Full Name | KRISTIN SULLIVAN |
| Credential | APRN |
| Practice Address |
1145 S Utica Ave Ste 460 Tulsa OK 74104-4041 |
| Practice Telephone | 9185795749 |
| Practice Fax Number | 9185795762 |
| Mailing Telephone | 9185795749 |
| Mailing Fax Number | 9185795762 |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2020-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 792822 | TX | Nursing Service Providers |
| N | 363L00000X | Nurse Practitioner | 86574 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | AP127645 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
86574 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LC0200X |
Nurse Practitioner Specialization: Critical Care Medicine |
86574 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154767853 | Kristin Anne Sullivan | Developmental Therapist | 6 Southside Rd, Danvers, MA 01923-1409 | 2013-05-21 |
| 1326380064 | Kristin Sullivan | Behavioral Analyst | 3170 E Sunset Rd, Suite A, Las Vegas, NV 89120-2745 | 2013-03-20 |
| 1194076620 | Kristin Marie Sullivan | Physician Assistant | 125 Parker Hill Ave, Converse 4, Boston, MA 02120-2847 | 2012-09-24 |
| 1063698066 | Kristin Sullivan | Physical Therapist | 1 Park Ave, Suite F, Mount Airy, MD 21771-5437 | 2008-01-21 |
| Street Address |
1145 S UTICA AVE STE 460 |
| City | TULSA |
| State | OK |
| Zip Code | 74104-4041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356376883 | Maak Attiya Dareshani | Internal Medicine | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2006-07-12 |
| 1588273569 | Steven Wingfield | Nurse Practitioner | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2020-07-27 |
| 1164069530 | Jennifer Marie Smith-woosley | Nurse Practitioner | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2019-12-04 |
| 1194361451 | Nada Shahab | Physician Assistant | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2019-11-21 |
| 1104384379 | Wendy Alexander | Nurse Practitioner | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2019-03-06 |
| 1659840213 | Crystal Lynn Jensen | Nurse Practitioner | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2018-11-13 |
| 1740767029 | Suma Thomas | Nurse Practitioner | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2018-07-19 |
| 1265925382 | Rebecca Shaffer | Physician Assistant | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2018-06-13 |
| 1609364314 | Velisa Davis | Nurse Practitioner | 1145 S Utica Ave Ste 460, Tulsa, OK 74104-4041 | 2018-04-27 |
| 1598264004 | Anjuli Shrestha | Physician Assistant | 1145 S Utica Ave Ste 460, Tulsa, OK 74104 | 2018-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
| Find all providers in zip 74104 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245657378 | Kelsey Schumacher | Nurse Practitioner | 1705 S 19th St., Ste 302, Tulsa, OK 74104 | 2014-03-26 |
| 1457528614 | Ingrid Patton | Nurse Practitioner | 2000 S Wheeling Ave Ste 200, Tulsa, OK 74104-5656 | 2008-05-15 |
| 1316551559 | Lauren Nicole Willems | Nurse Practitioner | 1265 S Utica Ave Ste 300, Tulsa, OK 74104-4243 | 2020-09-04 |
| 1730797523 | John Anthony Dean Maslin | Nurse Practitioner | 6465 S Yale Ave Ste 507, Tulsa, OK 74136-7807 | 2020-07-17 |
| 1922622869 | Emily Suku | Nurse Practitioner | 1705 E 19th St Ste 302, Tulsa, OK 74104-5410 | 2020-06-06 |
| 1760006886 | Tani Reynolds Calvert | Nurse Practitioner | 1923 S Utica Ave Fl 4, Tulsa, OK 74104-6520 | 2020-06-04 |
| 1720614373 | Michelle Diane Rivera | Nurse Practitioner | 1705 E 19th St Ste 302, Tulsa, OK 74104-5410 | 2020-03-16 |
| 1790318426 | Pavel Greg Buzadzhi | Nurse Practitioner | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2020-02-21 |
| 1962047563 | Houston Reed Slemp | Nurse Practitioner | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-11-07 |
| 1518518117 | Laura Whitaker | Nurse Practitioner | 2000 S Wheeling Ave Ste 510, Tulsa, OK 74104-5642 | 2019-09-25 |
| Find all providers in TULSA | ||||
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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.