LISA ANN SULLIVAN (NPI# 1952650236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952650236 |
| Entity Type | Individual |
| Full Name | LISA ANN SULLIVAN |
| Credential | NP |
| Practice Address |
3998 Fair Ridge Dr Ste 320 Fairfax VA 22033-2907 |
| Mailing Address |
3998 Fair Ridge Drive Suite 320 Fairfax VA 22033 |
| Practice Telephone | 7032959360 |
| Practice Fax Number | 7032959369 |
| Mailing Telephone | 7037669737 |
| Mailing Fax Number | 7037669725 |
| Enumeration Date | 2012-09-03 |
| Last Update Date | 2015-03-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
0024171328 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN58779 | DC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285282459 | Lisa Sullivan | Behavior Technician | 719 N Hillview Dr, Boise, ID 83712-8122 | 2019-08-29 |
| 1184183550 | Lisa Sullivan | Contractor | 113 Constitution Ct Apt A, Albany, GA 31721-2150 | 2019-03-15 |
| 1366875197 | Lisa Sullivan | Counselor | 3740 Colony Dr Ste 260, San Antonio, TX 78230-2233 | 2013-08-15 |
| 1336486414 | Lisa Marie Sullivan | Social Worker | 18 Rose Pl, Selden, NY 11784-3122 | 2013-01-10 |
| 1144579418 | Lisa Sullivan | Specialist | 252 California Ct, Mission Viejo, CA 92692-4098 | 2012-09-02 |
| 1811205750 | Lisa Renee Sullivan | Physician Assistant | 44305 Harmony Ln, Belleville, MI 48111-2449 | 2010-09-14 |
| 1700014065 | Lisa Hadeler Sullivan | Physical Therapist | 1420 Hwy 36, Hazlet, NJ 07730-1736 | 2009-06-25 |
| 1083874127 | Lisa Meghan Sullivan | Massage Therapist | 1640 Selby Ave Apt 6, Saint Paul, MN 55104-7379 | 2008-06-12 |
| 1841380375 | Lisa C. Sullivan | Pediatrics | 4950 Se Roethe Rd, Milwaukie, OR 97267-5746 | 2006-10-13 |
| 1386650273 | Lisa Marie Sullivan | Allergy & Immunology | 737 Saint Johns Ave, Highland Park, IL 60035-4650 | 2006-07-31 |
| Street Address |
3998 FAIR RIDGE DR STE 320 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22033-2907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326049396 | Ziad Yafi | Anesthesiology | 3998 Fair Ridge Dr, Suite 320, Fairfax, VA 22033-2921 | 2005-08-02 |
| 1265839062 | Angela Louise Plemmons | Registered Nurse | 3998 Fair Ridge Dr, Suite 300, Fairfax, VA 22033-2921 | 2014-11-24 |
| 1053735092 | Ahmed Rauf Qureshi | Nurse Anesthetist, Certified Registered | 3998 Fair Ridge Dr, Suite 320, Fairfax, VA 22033-2907 | 2014-02-11 |
| 1053732115 | Kelsey Schulman | Nurse Anesthetist, Certified Registered | 3998 Fair Ridge Dr, Suite 320, Fairfax, VA 22033-2907 | 2013-12-16 |
| 1992048409 | Melissa Anne Piskozub | Nurse Anesthetist, Certified Registered | 3998 Fair Ridge Dr, Suite 320, Fairfax, VA 22033-2907 | 2013-04-03 |
| 1144567942 | Julia Lee Wu | Physician Assistant | 3998 Fair Ridge Dr, Suite 300, Fairfax, VA 22033-2921 | 2013-01-14 |
| 1437454626 | Jose Antonio Mercado | Nurse Anesthetist, Certified Registered | 3998 Fair Ridge Dr, Fairfax, VA 22033-2907 | 2011-01-19 |
| 1598060121 | Jamie Michelle Kirby | Nurse Anesthetist, Certified Registered | 3998 Fair Ridge Dr, Suite 320, Fairfax, VA 22033-2907 | 2011-01-12 |
| 1700102571 | Celeste Twiford Owen | Nurse Anesthetist, Certified Registered | 3998 Fair Ridge Dr, Suite 300, Fairfax, VA 22033-2907 | 2010-04-19 |
| 1316102874 | Valerie Ann Gouzd | Anesthesiology | 3998 Fair Ridge Dr, Suite 320, Fairfax, VA 22033-2907 | 2008-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366074320 | Han S Yoo | Pharmacist | 12200 West Ox Road, Fairfax, VA 22033 | 2020-02-07 |
| 1386137271 | Ammar Orthodontics Pllc | Dentist | 11702 Fiar Oaks Mall, Upper Floor, Fairfax, VA 22033 | 2018-06-14 |
| 1013360940 | Kellyn Patricia Dodd | Nurse Practitioner | 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033 | 2016-07-15 |
| 1659721363 | John Du Od PC | Optometrist | 12618 Victoria Station Ct, Fairfax, VA 22033 | 2016-06-14 |
| 1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
| 1649696295 | Patrisha Lultschik | Nurse Practitioner | 12375 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2014-03-06 |
| 1912321910 | Alyson Huber | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr., Fairfax, VA 22033 | 2014-02-11 |
| 1578999314 | Aiatulah Surmaty | Optometrist | 11801 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2013-09-25 |
| 1356780928 | Ayatallah M. Khafagy | Obstetrics & Gynecology | 3650 Joseph Siewick Dr Suite 203, Fairfax, VA 22033 | 2013-06-17 |
| 1760726665 | Michelle Elise Schwartz | Speech-Language Pathologist | 3507 Curtice Farm Dr, Fairfax, VA 22033 | 2012-11-15 |
| Find all providers in zip 22033 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1033608989 | Liana Matevosian | Nurse Practitioner | 13104 Cross Keys Ct, Fairfax, VA 22033-1426 | 2018-05-07 |
| 1144674821 | Sonam Norbu | Nurse Practitioner | 4887 Wheatstone Dr, Fairfax, VA 22032-2341 | 2016-04-19 |
| 1992702617 | Mary Choisser Langford | Nurse Practitioner | 12011 Lee Jackson Hwy, Fairfax, VA 22033-3310 | 2005-07-07 |
| 1275179137 | Amelia Ellen Pitha | Nurse Practitioner | 8316 Arlington Blvd, Fairfax, VA 22031-5207 | 2019-11-25 |
| 1710530654 | Elizabeth Renshaw | Nurse Practitioner | 26136 Us Highway 59, Fairfax, MO 64446-9105 | 2019-07-19 |
| 1871998302 | Kimberly Soutuyo | Nurse Practitioner | 2722 Merrilee Dr, Suite 230, Fairfax, VA 22031-4420 | 2014-10-27 |
| 1063768539 | Zahra Mohseni | Nurse Practitioner | 8503 Arlington Blvd Ste 200, Fairfax, VA 22031-4629 | 2012-08-02 |
| 1265615041 | Hillary M Morris | Nurse Practitioner | 8503 Arlington Blvd, Suite 200, Fairfax, VA 22031-4628 | 2007-12-14 |
| 1629164389 | Mary L Duggan | Nurse Practitioner | 3650 Joseph Siewick Dr, 400, Fairfax, VA 22033-1710 | 2006-10-04 |
| Find all providers in FAIRFAX | ||||
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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.