MRS. STACEY ALLYSUN SULLIVAN (NPI# 1750861969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750861969 |
| Entity Type | Individual |
| Full Name | MRS. STACEY ALLYSUN SULLIVAN |
| Other Name | STACEY ALLYSUN LANSDOWNE |
| Credential | APNP |
| Practice Address |
2801 W Kinnickinnic River Pkwy Ste 260 Milwaukee WI 53215-3631 |
| Mailing Address |
3301 W Forest Home Ave Milwaukee WI 53215-2843 |
| Practice Telephone | 4146496780 |
| Practice Fax Number | 4146496030 |
| Mailing Telephone | 4146496780 |
| Mailing Fax Number | 4146496030 |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2020-03-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 197066 | WI | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | 8624 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
8624 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100080881 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 36500 Aurora Dr, Summit, WI 530664899 | 6022148834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447284088 | Stacey J Sullivan | Family Medicine | 16838 E Palisades Blvd Ste 153, Fountain Hills, AZ 85268-3791 | 2006-07-10 |
| 1669095642 | Stacey Geneva Sullivan | Massage Therapist | 2611 N Stevens St, Tacoma, WA 98407-4670 | 2020-05-25 |
| 1902158207 | Stacey Lynn Sullivan | Speech-Language Pathologist | 275 Cambridge St, Pob-3, Boston, MA 02114-3108 | 2012-10-10 |
| 1144597816 | Stacey Miglicco Sullivan | Nurse Practitioner | 8701 New Trails Dr, #150, The Woodlands, TX 77381-4253 | 2011-11-24 |
| 1891866646 | Stacey Lynn Sullivan | Physician Assistant | 1725 W Harrison St, Suite 408, Chicago, IL 60612 | 2006-11-13 |
| Street Address |
2801 W KINNICKINNIC RIVER PKWY STE 260 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53215-3631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205028487 | Jolita Satkus | Internal Medicine | 2801 W Kinnickinnic River Pkwy Ste 260, Milwaukee, WI 53215 | 2007-08-13 |
| 1245838838 | Tatiana Zaldua | Dietitian, Registered | 2801 W Kinnickinnic River Pkwy Ste 260, Milwaukee, WI 53215-3631 | 2020-10-15 |
| 1730669565 | Jenna Waite | Physician Assistant | 2801 W Kinnickinnic River Pkwy Ste 260, Milwaukee, WI 53215-3669 | 2018-08-21 |
| 1639697717 | Linsey Bishop | Dietitian, Registered | 2801 W Kinnickinnic River Pkwy Ste 260, Milwaukee, WI 53215-3631 | 2017-09-08 |
| 1366807208 | Maria T Sarandos | Nurse Practitioner | 2801 W Kinnickinnic River Pkwy Ste 260, Milwaukee, WI 53215-3631 | 2015-12-18 |
| 1467710897 | Laura R Folger | Nurse Practitioner | 2801 W Kinnickinnic River Pkwy Ste 260, Milwaukee, WI 53215-3631 | 2012-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841829918 | Joshua Michael Brooks | Student in an Organized Health Care Education/Training Program | Aurora St. Lukes Medical Center 2901 W Oklahoma Ave, Milwaukee, WI 53215 | 2020-04-02 |
| 1053967091 | Kristina Strupp | Clinical Nurse Specialist | 2900 W. Oaklahoma Avenue, Milwaukee, WI 53215 | 2019-08-15 |
| 1427510296 | Madelyn Pickle | Student in an Organized Health Care Education/Training Program | 2801 W. Kinnickinnic Rd Ste 250, Milwaukee, WI 53215 | 2019-04-02 |
| 1932601838 | Elizabeth D Morawski | Nurse Practitioner | 2801 Kinnickinnic Parkway, Suite 630, Milwaukee, WI 53215 | 2018-03-06 |
| 1457872673 | Canzata Kimberly Dent | Counselor | 2727 W. Cleveland Suite 204, Milwaukee, WI 53215 | 2017-06-28 |
| 1538689955 | Christian Pena | Durable Medical Equipment & Medical Supplies | 2800 W Forest Home Ave, Suite 100, Milwaukee, WI 53215 | 2017-06-27 |
| 1386178804 | Dane A Olsen | Family Medicine | 801 W Kinnickinnic River Pkwy., Suite 250, Milwaukee, WI 53215 | 2017-04-12 |
| 1811443492 | Thomas Diamond | Physical Therapist | 2901 Kinnickinnic Parkway, Milwaukee, WI 53215 | 2016-09-01 |
| 1487055133 | Sam Khalili | Otolaryngology | 2801 W Kinnickinnic River Pkwy # 680, Milwaukee, WI 53215 | 2014-09-12 |
| 1992105621 | Nicole R Hall | Nurse Practitioner | 2901 S Kinnickinnic Ave, Milwaukee, WI 53215 | 2014-08-29 |
| Find all providers in zip 53215 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952910010 | Dana Diane Broyles | Nurse Practitioner | 6500 W Ohio Ave, Milwaukee, WI 53219-4246 | 2020-07-24 |
| 1174149918 | Nicole Leigh Heding | Nurse Practitioner | 10421 W Birch Ave, Milwaukee, WI 53225-3211 | 2020-06-17 |
| 1841825759 | Brittany M Schoenick | Nurse Practitioner | 2901 W Kinnickinnic River Pkwy Ste 102, Milwaukee, WI 53215-3660 | 2020-03-11 |
| 1154960201 | Scottie-lynn Hecht | Nurse Practitioner | 1020 N 12th St Ste 102, Milwaukee, WI 53233-1308 | 2020-01-06 |
| 1518505064 | Jennifer Nelson | Nurse Practitioner | 7725 W Burleigh St, Milwaukee, WI 53222-5003 | 2019-12-16 |
| 1861043952 | Rosina Bloomingdale Norton | Nurse Practitioner | 1921 E Harford Ave, Milwaukee, WI 53211 | 2019-09-20 |
| 1275188393 | Candace Bentley | Nurse Practitioner | 3842 N 24th St, Milwaukee, WI 53206-1423 | 2019-08-06 |
| 1669934022 | Michaella Cariello-becker | Nurse Practitioner | 2500 W Layton Ave Ste 30-40, Milwaukee, WI 53221-5420 | 2019-04-04 |
| 1932601838 | Elizabeth D Morawski | Nurse Practitioner | 2801 Kinnickinnic Parkway, Suite 630, Milwaukee, WI 53215 | 2018-03-06 |
| 1457806390 | Katrina Buretta | Nurse Practitioner | 2901 W Kinnickinnic River Pkwy Ste 403, Milwaukee, WI 53215-3660 | 2016-08-21 |
| Find all providers in MILWAUKEE | ||||
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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.