JOAN M SULLIVAN (NPI# 1043393150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043393150 |
| Entity Type | Individual |
| Full Name | JOAN M SULLIVAN |
| Credential | PAC |
| Practice Address |
1675 Leahy St Suite 401a Muskegon MI 49442-5500 |
| Mailing Address |
Po Box 1847 Muskegon MI 49443-1847 |
| Practice Telephone | 2317274243 |
| Practice Fax Number | 2317274214 |
| Mailing Telephone | 2317274444 |
| Mailing Fax Number | 2317284789 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2017-02-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1046093 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5601003370 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | GROUP MEDICARE PTAN | MI1763 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205258498 | Joan E Sullivan | Pharmacist | 5918 Stoneridge Mall Road, Pleasanton, CA 94588 | 2014-01-08 |
| 1144372970 | Joan Sullivan | Contractor | 9010 Fitzsimmons Ave A, Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2007-01-18 |
| 1487656278 | Joan E Sullivan | Nurse Practitioner | 95 Soldiers Pass Rd, Suite A-2, Sedona, AZ 86336-4781 | 2005-08-11 |
| 1346240223 | Joan M Sullivan | Legal Medicine | 20 Arrowood Dr, Ithaca, NY 14850-1857 | 2005-07-21 |
| 1417393901 | Joan Marie Sullivan | Pharmacist | 2101 E Jefferson St, Rockville, MD 20852-4908 | 2013-05-11 |
| 1710007729 | Joan Marie Sullivan | Religious Nonmedical Nursing Personnel | 7559 263rd St, Glen Oaks, NY 11004-1150 | 2007-03-31 |
| 1689704728 | Joan M Sullivan | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2007-03-07 |
| 1851445373 | Joan Grant Sullivan | Psychiatry & Neurology | 1749 Martin Luther King Jr Way, Berkeley, CA 94709-2139 | 2007-01-22 |
| 1164496931 | Joan Lucille Sullivan | Occupational Therapist | 503 Grasslands Rd, Suite 105, Valhalla, NY 10595-1503 | 2006-02-16 |
| Street Address |
1675 LEAHY ST SUITE 401A |
| City | MUSKEGON |
| State | MI |
| Zip Code | 49442-5500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962405357 | Byron L Varnado | Family Medicine | 1675 Leahy St, Ste 301, Muskegon, MI 49442-5543 | 2005-05-31 |
| 1083269641 | Sheva Anayah Loncle | Physician Assistant | 1675 Leahy St, Muskegon, MI 49442-5500 | 2019-08-09 |
| 1790277101 | Felisa Saldutti | Student in an Organized Health Care Education/Training Program | 1675 Leahy St, Muskegon, MI 49442-5500 | 2018-05-31 |
| 1245768951 | Erin Nicole Deprekel | Student in an Organized Health Care Education/Training Program | 1675 Leahy St, Muskegon, MI 49442-5500 | 2017-05-24 |
| 1659807709 | Irfan Ahmed Khan | Student in an Organized Health Care Education/Training Program | 1675 Leahy St, Suite 201a, Muskegon, MI 49442-5500 | 2017-05-11 |
| 1740715689 | William Brady Alling | Student in an Organized Health Care Education/Training Program | 1675 Leahy St, Suite 201a, Muskegon, MI 49442-5500 | 2017-04-28 |
| 1093240103 | Cassondra Wass | Student in an Organized Health Care Education/Training Program | 1675 Leahy St, Suite 201a, Muskegon, MI 49442-5500 | 2017-04-26 |
| 1740713551 | Brynn Schumacher | Student in an Organized Health Care Education/Training Program | 1675 Leahy St, Suite 315, Muskegon, MI 49442-5500 | 2017-04-07 |
| 1083156723 | Sara Farwig | Physician Assistant | 1675 Leahy St, Suite 324b, Muskegon, MI 49442-5500 | 2016-11-11 |
| 1336590728 | Eliza Newbury-palma | Family Medicine | 1675 Leahy St, Suite 315a, Muskegon, MI 49442-5500 | 2016-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205472321 | Beacon of Light Counseling LLC | Social Worker | 1515 E Laketon Ave, Muskegon, MI 49442 | 2019-11-24 |
| 1528524410 | Tyler Companion | Social Worker | 710 Mclaughlin, Muskegon, MI 49442 | 2019-02-15 |
| 1427549658 | Amber Renee Davidson | Behavioral Analyst | 1175 Wesley Street, Muskegon, MI 49442 | 2018-05-23 |
| 1528559085 | Katherine Dale Kirby | Obstetrics & Gynecology | Mercy Health Hackley, 1700 Clinton St., Muskegon, MI 49442 | 2018-05-21 |
| 1023524303 | Aaron James Dortch | Social Worker | 571 E Appleave, Muskegon, MI 49442 | 2017-12-21 |
| 1043737554 | Jessica Nicole Moskalewski | Social Worker | 125 E. Catherine, Muskegon, MI 49442 | 2017-08-25 |
| 1427587831 | Cristina J Walcott | Social Worker | 1611 Oak Avenue, Muskegon, MI 49442 | 2017-06-08 |
| 1104352244 | Jessica Lee Bailey-yabani | Counselor | 35 S Sheridan Dr, Muskegon, MI 49442 | 2017-05-11 |
| 1538514518 | Andrew G Gregson | Internal Medicine | 1675 Leahy Street Suite 201a, Muskegon, MI 49442 | 2016-04-27 |
| 1487038287 | Mark Charles Kaufman | Social Worker | 1611 Oak Ave., Muskegon, MI 49442 | 2015-07-13 |
| Find all providers in zip 49442 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619368008 | Matthew Eisen | Physician Assistant | 1560 E Sherman Blvd Ste 9, Muskegon, MI 49444-1867 | 2015-02-06 |
| 1114990447 | Julie A Anderson | Physician Assistant | 1560 E Sherman Blvd Ste 309, Muskegon, MI 49444-1850 | 2006-02-08 |
| 1275635898 | Shannon M Jansma | Physician Assistant | 1325 E Sherman Blvd, Muskegon, MI 49444-1813 | 2006-09-03 |
| 1922047042 | Maria Jessica Parsons | Physician Assistant | 1560 E Sherman Blvd, Suite 309, Muskegon, MI 49444-1867 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841835303 | Gerard M Lefebvre Jr. | Physician Assistant | 5301 Mcauley Dr Ste 5112, Ypsilanti, MI 48197-1051 | 2019-11-08 |
| 1548611023 | Michael Scott Schaeffer II | Physician Assistant | 58070 Montego Dr, New Hudson, MI 48165-9735 | 2016-06-27 |
| 1700248176 | Katilyn Kohl | Physician Assistant | 3990 John R St Ste 4905, Detroit, MI 48201-2018 | 2016-03-24 |
| 1881052363 | Surgical Assist, Plc | Physician Assistant | 4409 Gaylord Dr, Troy, MI 48098-4458 | 2016-01-29 |
| 1710342134 | Evan Reid Vandenbosch | Physician Assistant | 36622 5 Mile Rd, Suite 101, Livonia, MI 48154-1900 | 2015-12-30 |
| 1609214972 | Jennifer Lynn Krishnan | Physician Assistant | 3601 E 13 Mile Rd, Royal Oak, MI 48073-6769 | 2013-06-10 |
| 1093028441 | Lonna Petronella Van Ast | Physician Assistant | 1022 Ada Place Dr Se, Grand Rapids, MI 49546-3786 | 2010-07-14 |
| 1669707170 | Luke Thomas Dillon | Physician Assistant | 3100 Cross Creek Pkwy Ste 200, Auburn Hills, MI 48326-2776 | 2009-10-16 |
| 1912139544 | Richard Lawrence Burgett Sr. | Physician Assistant | 4327 Stone Ridge Dr, Traverse City, MI 49684-7958 | 2009-08-15 |
| 1881822187 | Shea Mace | Physician Assistant | 6799 West Grand Blvd, Detroit, MI 48202 | 2009-06-24 |
| 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.