MISS THEA DELORA SULLIVAN (NPI# 1356584379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356584379 |
| Entity Type | Individual |
| Full Name | MISS THEA DELORA SULLIVAN |
| Credential | RN |
| Practice Address |
3628 River Heights Xing Se Marietta GA 30067-4870 |
| Practice Telephone | 7702720716 |
| Mailing Telephone | 7702720716 |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2009-04-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP2201X |
Registered Nurse Specialization: Ambulatory Care |
RN196107 | GA | Nursing Service Providers |
| Street Address |
3628 RIVER HEIGHTS XING SE |
| City | MARIETTA |
| State | GA |
| Zip Code | 30067-4870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689140022 | Sherry Wilson King | Marriage & Family Therapist | 1640 Powers Ferry Rd Blg 7, Ste 300, Marietta, GA 30067 | 2018-10-23 |
| 1053886861 | Precious Angel Home Care Services Inc | Adult Companion | 2470 Windy Hill Road, Marietta, Suite 253, Marietta, GA 30067 | 2018-10-08 |
| 1194206466 | Joshua P Moree | Chiropractor | 860 Franklin Gtwy Se Apt 111, Marietta, GA 30067 | 2018-08-24 |
| 1841778081 | Sun Pediatrics LLC | Pediatrics | 2520 Windy Hill Rd Se Ste 104, Marietta, GA 30067 | 2018-07-31 |
| 1508358714 | Mbs Wellness Group, LLC | Durable Medical Equipment & Medical Supplies | 62 Shawnee Trail Se, Marietta, GA 30067 | 2018-06-04 |
| 1497254213 | Allison M Jancik | Chiropractor | 1355 Terrell Mill Road Se, Bldg 1474, Ste 150, Marietta, GA 30067 | 2018-02-07 |
| 1801304969 | Danielle Ann Dietrich | Chiropractor | 805 Winterset Pkwy Se, Marietta, GA 30067 | 2018-01-11 |
| 1740794866 | Jessica Lofgren | Chiropractor | 1130 Northchase Pkwy Se Ste 125, Marietta, GA 30067 | 2017-11-28 |
| 1871026393 | Rhonda Dawes Milner | Counselor | 1640 Powers Ferry Rd Bldg 16, Suite 100, Marietta, GA 30067 | 2017-04-11 |
| 1457894537 | Carcelia Delk | Counselor | 1110 Augusta Dr Se, Marietta, GA 30067 | 2016-11-22 |
| Find all providers in zip 30067 | ||||
| Taxonomy Code | 163WP2201X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Ambulatory Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003281726 | Kendra Shearer | Registered Nurse | 1241 Channel Park Sw, Marietta, GA 30064-3825 | 2015-12-07 |
| 1922202142 | George Steve Hardman | Registered Nurse | 1640 Powers Ferry Rd Bldg 23, Marietta, GA 30067-1455 | 2007-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194335182 | Rhonda Gabel | Registered Nurse | 14 Legacy Way Ste A, Adairsville, GA 30103-2455 | 2020-08-04 |
| 1053713537 | Renee Arnette Charlton Brown | Registered Nurse | 89 Arcadia Dr, Midway, GA 31320-3070 | 2014-09-16 |
| 1407257835 | Phillip Volkert | Registered Nurse | 1233 Brooklet South Dr, Brooklet, GA 30415-6469 | 2014-09-04 |
| 1215337738 | Sunny Park | Registered Nurse | 13 Splitleaf Ct, Savannah, GA 31419-9656 | 2014-09-03 |
| 1104174531 | Mamboh Ngum Yufenyuy | Registered Nurse | 1657 Southgate Mill Dr Nw, Duluth, GA 30096 | 2012-08-15 |
| 1780751297 | Mobile Healthcare | Registered Nurse | 4749 Limestone Ln Nw, Acworth, GA 30102-6484 | 2006-11-29 |
| 1215969522 | Mary Emily Walker I | Registered Nurse | 421 Shyrewood Dr, Lawrenceville, GA 30043-6452 | 2006-07-07 |
| 1861012874 | Jaime Floyd | Registered Nurse | 231 W Hancock St, Milledgeville, GA 31061-3375 | 2020-04-20 |
| 1033766076 | Anagha Cupples | Registered Nurse | 4500 N Shallowford Rd, Atlanta, GA 30338-6476 | 2019-08-23 |
| 1184101297 | Valencia Mitonya Covington | Registered Nurse | 1170 Cleveland Ave, East Point, GA 30344-3615 | 2018-07-20 |
| 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.