KELLY ELIZABETH SULLIVAN (NPI# 1427549088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427549088 |
| Entity Type | Individual |
| Full Name | KELLY ELIZABETH SULLIVAN |
| Credential | AGNP-C |
| Practice Address |
428 Hartford Tpke Ste 207 Vernon CT 06066-4841 |
| Practice Telephone | 8608725426 |
| Enumeration Date | 2018-05-19 |
| Last Update Date | 2018-05-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
390200000X | CT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144832205 | Kelly E Sullivan | Nurse Practitioner | 10020 Southern Maryland Blvd Ste 202, Dunkirk, MD 20754-3055 | 2020-08-20 |
| 1124670724 | Kelly Elizabeth Sullivan | Occupational Therapy Assistant | 12 Deforest Rd, Lansdowne, PA 19050-2109 | 2019-07-12 |
| 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 |
428 HARTFORD TPKE STE 207 |
| City | VERNON |
| State | CT |
| Zip Code | 06066-4841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528554094 | Scott Arnold Mcintyre | Registered Nurse | 428 Hartford Tpke Ste 207, Vernon, CT 06066-4841 | 2018-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659992204 | Kumeh Bestman | Social Worker | 41 Jeff Road, Vernon, CT 06066 | 2020-05-05 |
| 1114567922 | Irina Bratan | Nurse Practitioner | 35 Talcottvile Road, Vernon, CT 06066 | 2020-01-09 |
| 1457833899 | Jessica Elizabeth Navallil | Pharmacist | 188 Union Street, Vernon, CT 06066 | 2018-09-02 |
| 1528557709 | Andre Spence | Counselor | 66 Orchard St, Vernon, CT 06066 | 2018-05-03 |
| 1992207468 | Myeyedr Optometry of Connecticut, LLC | Optometrist | 400-1 Talcottville Rd, Vernon, CT 06066 | 2018-03-01 |
| 1811425754 | Patricia Cosgrove Barresi | Occupational Therapy Assistant | 1253 Hartford Turnpike, Vernon, CT 06066 | 2017-05-23 |
| 1922539592 | Ctuc01 | Clinic/Center | 179 Talcottville Rd, Vernon, CT 06066 | 2017-03-24 |
| 1558804070 | First Choice Health Centers, Inc. | Clinic/Center | 94 Union Sreet, 2nd Floor, Vernon, CT 06066 | 2016-12-01 |
| 1235685504 | Lotus Behavioral Consultation | Day Training, Developmentally Disabled Services | 3 Raymond Street, Vernon, CT 06066 | 2016-08-28 |
| 1891179537 | Heather Deal | Nurse Practitioner | 347 Hartford Turnpike, Vernon, CT 06066 | 2015-07-13 |
| Find all providers in zip 06066 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912425166 | Wendy Greta Sperry | Nurse Practitioner | 428 Hartford Tpke, Vernon, CT 06066-4841 | 2017-09-07 |
| 1134132178 | Angela E Lanza | Nurse Practitioner | 554 Talcottville Rd, Vernon, CT 06066-2310 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578161170 | Lisa B Stein | Nurse Practitioner | 861 Brooklawn Ave, Fairfield, CT 06825-1809 | 2020-10-15 |
| 1194322800 | Constantin Razvan Popescu | Nurse Practitioner | 46 Summer View Dr, Monroe, CT 06468-2001 | 2020-10-06 |
| 1538785902 | Lms Health LLC | Nurse Practitioner | 2001 W Main St Ste 244, Stamford, CT 06902-4544 | 2020-06-22 |
| 1760001010 | Mobile Care Partners of Connecticut Pllc | Nurse Practitioner | 44 Luzi Dr Apt 960, Bantam, CT 06750-1619 | 2020-04-15 |
| 1740811454 | Melissa Jennifer Mokel | Nurse Practitioner | 122 Cornerstone Dr, South Windsor, CT 06074-6303 | 2020-01-31 |
| 1861037533 | Olga Poznyur | Nurse Practitioner | 19 Woodland St Ste 21, Hartford, CT 06105-2372 | 2019-11-16 |
| 1356996904 | Virginia Tran | Nurse Practitioner | 39 Maple Tree Ave Unit 34, Stamford, CT 06906-2273 | 2019-08-09 |
| 1336705839 | Rose-ann Cashema Richards | Nurse Practitioner | 34 Heather Ln, Manchester, CT 06040-6903 | 2019-05-10 |
| 1144706631 | Chana Judith Hoagland | Nurse Practitioner | 276 Quarry Brook Drive, South Windsor, CT 06074 | 2018-07-17 |
| 1639668031 | Katherine Wargo | Nurse Practitioner | 66 Acorn Rd, Madison, CT 06443-3340 | 2018-05-02 |
| Find all providers with the same taxonomy | ||||
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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.