JENNIFER MAE SULLIVAN (NPI# 1053584789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053584789 |
| Entity Type | Individual |
| Full Name | JENNIFER MAE SULLIVAN |
| Credential | WHNP |
| Practice Address |
500 Osborne Rd Ne Suite 200 Fridley MN 55432-2774 |
| Mailing Address |
2925 Chicago Ave Minneapolis MN 55407-1321 |
| Practice Telephone | 7637866011 |
| Mailing Telephone | 6122625000 |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2016-02-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
R1564338 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851907232 | Jennifer Sullivan | Massage Therapist | 82884 N Pacific Hwy, Creswell, OR 97426-9407 | 2020-09-21 |
| 1033778360 | Jennifer Sullivan | Registered Nurse | 3703 Stearns Hill Rd, Waltham, MA 02451-7134 | 2019-06-11 |
| 1558820290 | Jennifer Sullivan | Specialist/Technologist | 6799 Krenson Oaks Cir, Lakeland, FL 33810-2157 | 2019-03-12 |
| 1043780364 | Jennifer P Sullivan | Lactation Consultant, Non-RN | 33 Arlington Ave Ste 4, Poughkeepsie, NY 12603-1603 | 2018-11-29 |
| 1942750484 | Jennifer Sullivan | Physical Therapy Assistant | 518 Phillips Rd # A, Levant, ME 04456-4446 | 2016-10-07 |
| 1770953051 | Jennifer Sullivan | Occupational Therapy Assistant | 3815 W Mason Rd, Deer Park, WA 99006-9511 | 2015-09-30 |
| 1720470552 | Jennifer M Sullivan | Specialist | 88 Slocum Ave, Tappan, NY 10983-2610 | 2015-03-03 |
| 1093122475 | Jennifer Sullivan | Nurse Practitioner | 15 Gracelawn Rd Ste 203, Auburn, ME 04210-6344 | 2014-07-17 |
| 1164778635 | Jennifer Sullivan | Early Intervention Provider Agency | 51 Churchill Ln, Smithtown, NY 11787-4039 | 2012-08-02 |
| 1881956472 | Jennifer Sullivan | Specialist | 4663 189th St, Flushing, NY 11358-3834 | 2012-06-11 |
| Street Address |
500 OSBORNE RD NE SUITE 200 |
| City | FRIDLEY |
| State | MN |
| Zip Code | 55432-2774 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407851694 | Crystal M Dexter | Family Medicine | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2774 | 2005-06-15 |
| 1083152367 | Angela Bennett | Pediatrics | 500 Osborne Rd Ne, Suite 215, Fridley, MN 55432-2765 | 2017-02-07 |
| 1902263866 | Jennifer Alma Wilson | Registered Nurse | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2774 | 2016-01-24 |
| 1689067860 | Mona Abdel-bary | Family Medicine | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2765 | 2015-03-11 |
| 1073935219 | Jill Marrone | Dietitian, Registered | 500 Osborne Rd Ne, Suite 200, Fridley, MN 55432-2765 | 2014-01-07 |
| 1164844304 | Michelle Mezera | Dietitian, Registered | 500 Osborne Rd Ne, Suite 200, Fridley, MN 55432-2765 | 2014-01-07 |
| 1720315567 | Cities Lung Clinic Pa | Internal Medicine | 500 Osborne Rd Ne, Suite 360, Fridley, MN 55432-2783 | 2009-11-16 |
| 1932341252 | Lucie Larson | Obstetrics & Gynecology | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2765 | 2009-04-01 |
| 1437399250 | Advanced Cosmetic & Plastic Surgery | Specialist | 500 Osborne Rd Ne, Suite 130, Fridley, MN 55432-2765 | 2009-03-06 |
| 1255588299 | Metropolitan Cardiology Consultants | Specialist | 500 Osborne Rd Ne, Suite 120, Fridley, MN 55432-2765 | 2008-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
| 1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
| 1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
| 1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
| 1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
| 1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
| 1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
| 1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
| Find all providers in zip 55432 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538322243 | Nicole Kay Baker | Nurse Practitioner | 500 Osborne Rd Ne Ste 255, Fridley, MN 55432-2768 | 2008-07-03 |
| 1154423069 | Ann K. Murtaugh | Nurse Practitioner | 6341 University Ave Ne, Fridley, MN 55432-4946 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013547850 | Lexie Frances Polk | Nurse Practitioner | 3520 N Shore Dr, Wayzata, MN 55391-9360 | 2020-01-21 |
| 1790341865 | Natalie Nicole Johnson | Nurse Practitioner | 9550 Upland Ln N Ste 230, Maple Grove, MN 55369-4484 | 2019-05-14 |
| 1326519646 | Kelsey M Thompson | Nurse Practitioner | 2920 Aldrich Ave S Apt 145, Minneapolis, MN 55408-4275 | 2018-12-13 |
| 1134647274 | Lisa Bergman | Nurse Practitioner | 201 N Victory Dr Ste 211, Mankato, MN 56001-5398 | 2017-09-08 |
| 1528450053 | Stephanie Nielsen | Nurse Practitioner | 1979 Sotlich Rd, Ely, MN 55731-8239 | 2015-02-20 |
| 1366842734 | Meghan Stommes | Nurse Practitioner | 801 Nicollet Mall Ste 400, Minneapolis, MN 55402-2520 | 2014-09-03 |
| 1659710887 | Jessica Williams | Nurse Practitioner | 451 E Saint Germain St Ste 100, Saint Cloud, MN 56304-0761 | 2013-06-20 |
| 1437496700 | Toby Faye Sawyer | Nurse Practitioner | 1001 E Central Entrance Ste 200, Duluth, MN 55811-5525 | 2013-01-07 |
| 1093096927 | Laura J Wilner | Nurse Practitioner | 803 Belsly Blvd # 2, Moorhead, MN 56560-5057 | 2011-09-06 |
| 1861720062 | Linda Marie Christinsen-rengel | Nurse Practitioner | 640 Jackson Street Ms 11101a, Healthpartners Regions Specialty Clinics, Saint Paul, MN 55101 | 2009-11-27 |
| 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.