HEIDI SULLIVAN (NPI# 1295188498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295188498 |
| Entity Type | Individual |
| Full Name | HEIDI SULLIVAN |
| Other Name | HEIDI HASBROUCK |
| Credential | NP |
| Practice Address |
102 Bryan Woods Road Savannah GA 31410-1225 |
| Mailing Address |
836 E. 65th Street Suite 20 Savannah GA 31405 |
| Practice Telephone | 9128981122 |
| Practice Fax Number | 9128989944 |
| Mailing Telephone | 9128197878 |
| Mailing Fax Number | 9128193555 |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2019-05-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN106514 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003181045B | 05 |
| Street Address |
102 BRYAN WOODS ROAD |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31410-1225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366431660 | Milagros Rivera | Family Medicine | 102 Bryan Woods Road, Savannah, GA 31410 | 2005-10-19 |
| 1730238254 | Ellen Harris Richardson | Family Medicine | 102 Bryan Woods Road, Ellen Richardson Md, Savannah, GA 31410-1225 | 2007-01-10 |
| 1598829863 | James M Mcneely | Internal Medicine | 102 Bryan Woods Road, Savannah, GA 31410 | 2006-12-21 |
| 1811913486 | Candler Medical Group, Inc. - Islands | Family Medicine | 102 Bryan Woods Road, Savannah, GA 31410-1225 | 2006-07-15 |
| 1538194634 | Richard John Barrett Jr. | Internal Medicine | 102 Bryan Woods Road, Savannah, GA 31410-1225 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144708249 | Madison Allee Horton | Physical Therapist | 461 Johnny Mercer Blvd Ste C2, Savannah, GA 31410 | 2018-07-31 |
| 1740706449 | Stacy Jane Slaght | General Practice | 151 Three Mast Ct, Savannah, GA 31410 | 2017-08-15 |
| 1851816631 | Mary Elizabeth Pennington | Physical Therapy Assistant | 702 Leaning Oaks Dr, Savannah, GA 31410 | 2017-08-14 |
| 1568901353 | Islands Chiropractic Clinic | Health Maintenance Organization | 461 Johnny Mercer Blvd. Suite3, Savannah, GA 31410 | 2017-02-14 |
| 1033598479 | Erica Blaikie Young | Family Medicine | 51 Johnny Mercer Blvd. Cottage A-1, Savannah, GA 31410 | 2015-05-19 |
| 1013257344 | Stephanie Denise Tootle | Obstetrics & Gynecology | 1004 Memorial Ln Ste 500, Savannah, GA 31410 | 2013-02-23 |
| 1275837791 | Johane Cam Harrigan | Clinic/Center | 124 Ropemaker Lane, 124 Rpemaker Lane, Savannah, GA 31410 | 2010-12-23 |
| 1497085385 | Kelli Suzanne Littlefield | Counselor | 100 Blue Fin Cir Ste 4, Savannah, GA 31410 | 2009-12-28 |
| 1720111040 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 148 Sea Palms Road, Savannah, GA 31410 | 2007-03-14 |
| 1265576201 | Whitemarsh Chiropractic Center, PC | Chiropractor | 115-a Charlotte Road, Savannah, GA 31410 | 2007-02-15 |
| Find all providers in zip 31410 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316820 | Odyne Rose Lacossiere-dorvilus | Nurse Practitioner | 30 Myrtlewood Dr, Savannah, GA 31405-1024 | 2020-11-06 |
| 1952900383 | Micaiah Mitchell | Nurse Practitioner | 10612 Middleground Rd Apt 513, Savannah, GA 31419-1268 | 2020-10-17 |
| 1104424712 | Yolanda Michelle Miller | Nurse Practitioner | 1651 Mckinnon Dr, Savannah, GA 31404-2319 | 2020-10-15 |
| 1730795386 | Shanika Graham | Nurse Practitioner | 2330 Coakley St, Savannah, GA 31404-4947 | 2020-09-18 |
| 1508479775 | Tonya L Creasy | Nurse Practitioner | 170 Barker Dr, Savannah, TN 38372-8419 | 2020-08-28 |
| 1356952394 | Elizabeth Woods Hammond | Nurse Practitioner | 107 W Liberty St Apt 6, Savannah, GA 31401-3965 | 2020-08-13 |
| 1740898915 | Bryan S Christain | Nurse Practitioner | 340 Hodgson Ct Ste 2, Savannah, GA 31406-1523 | 2020-07-14 |
| 1841814753 | Billie Sweeney | Nurse Practitioner | 134 Horse Creek Rd, Savannah, TN 38372-2984 | 2020-06-05 |
| 1609401140 | Malika Anderson Batie | Nurse Practitioner | 1632 Cloverdale Dr, Savannah, GA 31415-7814 | 2020-03-05 |
| 1760017206 | Evelia Johnsen | Nurse Practitioner | 11702 Mercy Blvd Ste 2g, Savannah, GA 31419-1777 | 2020-03-05 |
| Find all providers in SAVANNAH | ||||
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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.