TIYIKA SULLIVAN (NPI# 1063803740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063803740 |
| Entity Type | Individual |
| Full Name | TIYIKA SULLIVAN |
| Practice Address |
4692 Brownsboro Rd Winston Salem NC 27106-3410 |
| Mailing Address |
4692 Brownsboro Rd Winston Salem NC 27106-0000 |
| Practice Telephone | 3362511114 |
| Practice Fax Number | 3362511115 |
| Mailing Telephone | 3362511114 |
| Mailing Fax Number | 3362511115 |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-04-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
5007480 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4692 BROWNSBORO RD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27106-3410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376541581 | Nagaraja Vishakantaiah | Family Medicine | 4692 Brownsboro Rd, Winston Salem, NC 27106-3410 | 2005-07-12 |
| 1700402674 | Chelsey Rae Stovall | Registered Nurse | 4692 Brownsboro Rd, Winston Salem, NC 27106-3410 | 2020-06-17 |
| 1073147393 | Kimberly Elizabeth Potter | Nurse Practitioner | 4692 Brownsboro Rd, Winston Salem, NC 27106-3410 | 2020-02-25 |
| 1417592080 | Lee Yarber | Nurse Practitioner | 4692 Brownsboro Rd, Winston Salem, NC 27106-3410 | 2019-11-07 |
| 1669015202 | Allona Frazier | Nurse Practitioner | 4692 Brownsboro Rd, Winston Salem, NC 27106-3410 | 2019-10-28 |
| 1063072130 | Danielle Nichole Stovall | Nurse Practitioner | 4692 Brownsboro Rd, Winston Salem, NC 27106-3410 | 2019-06-19 |
| 1407314818 | Erin Maeve Morrison | Physician Assistant | 4692 Brownsboro Rd, Winston Salem, NC 27106-3410 | 2019-03-05 |
| 1811467871 | Karen Griffin Taylor | Nurse Practitioner | 4692 Brownsboro Rd, Winston Salem, NC 27106-3410 | 2018-12-03 |
| 1225527617 | Cassandra Dawn Restrepo | Nurse Practitioner | 4692 Brownsboro Rd, Winston Salem, NC 27106 | 2018-05-01 |
| 1659880516 | Jennifer Winn Powell | Registered Nurse | 4692 Brownsboro Rd, Winston Salem, NC 27106 | 2017-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437799103 | Tyler Laura Lawrence | Behavioral Analyst | 1959 N Peace, 104, Winston-salem, NC 27106 | 2020-01-10 |
| 1316504624 | Amanda Baker | Behavior Technician | 1959 N Peace Haven Rd, Suite 104, Winston Salem, NC 27106 | 2019-05-22 |
| 1679030316 | Lavonda Williams | Behavior Technician | 1959 N Peace Haven Road, Winston Salem, NC 27106 | 2019-03-01 |
| 1518436708 | Angela Ruth Brown | Physical Therapy Assistant | 190 Moravian Way Drive, Winston-salem, NC 27106 | 2018-11-16 |
| 1407378896 | Applied Family Services of Winston-salem | Early Intervention Provider Agency | 4220 Witherow Rd, Winston Salem, NC 27106 | 2017-07-07 |
| 1750801676 | Julia Ann Horton | Speech-Language Pathologist | 2000 Salemtowne Drive, Winston Salem, NC 27106 | 2017-06-21 |
| 1124548037 | Tyler John Jones | Community Health Worker | 7014 Brandemere Ln. Apt F, Winston Salem, NC 27106 | 2017-06-21 |
| 1396274759 | Jennifer Cui | Social Worker | 3216 Cross Tree Rd, Winston-salem, NC 27106 | 2017-06-08 |
| 1063947802 | Rebecca Jeanette Mclemore | Social Worker | 4401 Providence Ln. #121, Top Priority Care Services, LLC., Winston-salem, NC 27106 | 2017-05-01 |
| 1720529357 | Rising Hope Clinical Assistance, LLC | Community/Behavioral Health | 510 Northgate Park Dr, Winston Salem, NC 27106 | 2017-03-15 |
| Find all providers in zip 27106 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073915880 | Elena Kay Bedingfield | Nurse Practitioner | 639 S Green St, Winston Salem, NC 27101-5109 | 2014-09-23 |
| 1457543365 | Judy Ann Shives | Nurse Practitioner | 1100 Reynolds Blvd, Winston Salem, NC 27105-3400 | 2007-08-14 |
| 1376765925 | Robert Clark | Nurse Practitioner | Employee and Occupational Health, Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2007-05-03 |
| 1851446728 | Patricia Kearney | Nurse Practitioner | 147 Columbine Dr, Winston Salem, NC 27106-3112 | 2007-01-23 |
| 1427012301 | Carol A Brown | Nurse Practitioner | 3880 Vest Mill Rd, Suite 100, Winston Salem, NC 27103-1323 | 2006-04-17 |
| 1366963589 | Wendy Rash | Nurse Practitioner | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2017-06-28 |
| 1255794855 | Cheri Taylor | Nurse Practitioner | 615 Saint George Square Ct Ste 300, Winston Salem, NC 27103-1368 | 2016-03-31 |
| 1154789170 | Emma B Denny | Nurse Practitioner | Medical Center Blvd, Winston Salem, NC 27157-2444 | 2016-02-04 |
| 1558726745 | Kristin Suzanne Mcnally | Nurse Practitioner | 4692 Brownsboro Rd, Winston Salem, NC 27106-3410 | 2015-12-15 |
| 1316361470 | Karen Pfotenhauer | Nurse Practitioner | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2014-02-10 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27106 |
Please comment or provide details below to improve the information on TIYIKA SULLIVAN.
| 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.