JUDITH EILEEN SULLIVAN (NPI# 1083880181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083880181 |
| Entity Type | Individual |
| Full Name | JUDITH EILEEN SULLIVAN |
| Credential | ANP |
| Practice Address |
223 W State St Boise ID 83702-6013 |
| Mailing Address |
43 Golden Eagle Dr Boise ID 83716-3217 |
| Practice Telephone | 2083430436 |
| Mailing Telephone | 2083430436 |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2008-05-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
CNS36A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659401347 | Judith Ann Sullivan | Licensed Vocational Nurse | 2453 Morgan Ave, Bronx, NY 10469-5705 | 2007-03-06 |
| 1417000951 | Judith Sullivan | Nurse Practitioner | Mass General Hospital Racu Bigelow 9, Fruit St, Boston, MA 02114 | 2007-01-19 |
| 1144264748 | Judith A Sullivan | Nurse Practitioner | 170 Alameda De Las Pulgas, Redwood Pulmonary Medical Assoc., Redwood City, CA 94062 | 2006-06-15 |
| Street Address |
223 W STATE ST |
| City | BOISE |
| State | ID |
| Zip Code | 83702-6013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760434302 | Kristen Fiorentino | Internal Medicine | 223 W State St, St. C, Boise, ID 83702-6013 | 2006-05-16 |
| 1053469551 | Rebecca K Stone | Nurse Practitioner | 223 W State St, Boise, ID 83702-6013 | 2007-01-08 |
| 1932269784 | Jana Kae Thomas | Counselor | 223 W State St, Boise, ID 83702-6013 | 2006-12-11 |
| 1982772117 | Susan L Farber | Psychologist | 223 W State St, Boise, ID 83702-6013 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 364SP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942201520 | Mary A Curtis | Clinical Nurse Specialist | 8100 W Emerald St, Suite 150, Boise, ID 83704-9055 | 2005-08-09 |
| 1952622524 | Affinity, Inc. | Clinical Nurse Specialist | 8100 W Emerald St Ste 150, Boise, ID 83704-9057 | 2010-06-18 |
| 1316996309 | Deborah Gay Butte | Clinical Nurse Specialist | 300 S 23rd St, Boise, ID 83702-9100 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669408860 | Jane E Seys | Clinical Nurse Specialist | 13500 S. Pleasant Valley Rd, Idaho State Correctional Institution, Kuna, ID 83634 | 2006-06-23 |
| 1871753061 | Elisabeth Gayle Kinghorn | Clinical Nurse Specialist | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2008-06-11 |
| 1619998713 | Connie J Judd | Clinical Nurse Specialist | 223 16th Ave N, Nampa, ID 83687-4058 | 2006-07-22 |
Please comment or provide details below to improve the information on JUDITH EILEEN 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.