DR. ATINA LORENE SULLIVAN (NPI# 1508351024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508351024 |
| Entity Type | Individual |
| Full Name | DR. ATINA LORENE SULLIVAN |
| Credential | NURSE PRACTITIONER |
| Practice Address |
1202 Annapolis Rd Odenton MD 21113-1397 |
| Mailing Address |
3205 Dorstone Pl Upper Marlboro MD 20774-8099 |
| Practice Telephone | 4106722862 |
| Mailing Telephone | 3136736928 |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2020-09-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AC002341 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1447 York Rd Ste 506, Lutherville, MD 210936022 | 4108252281 | |
| 5401 Old Court Rd, Randallstown, MD 211335103 | 4108252281 |
| Street Address |
1202 ANNAPOLIS RD |
| City | ODENTON |
| State | MD |
| Zip Code | 21113-1397 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912075128 | Thomas Kenny Hyland Robertson | Chiropractor | 1202 Annapolis Rd, Suite I, 2nd Flr, Odenton, MD 21113-1397 | 2006-12-04 |
| 1790391522 | Nature Josette Duran-smith | Social Worker | 1202 Annapolis Rd, Odenton, MD 21113-1397 | 2020-09-17 |
| 1649819830 | Humanim Supported Employment Aa | Community/Behavioral Health | 1202 Annapolis Rd, Odenton, MD 21113-1397 | 2020-01-06 |
| 1558928366 | Andrea Dabney Boyd | Social Worker | 1202 Annapolis Rd, Odenton, MD 21113-1397 | 2019-05-28 |
| 1346606365 | Humanim Supported Employment Aa | Case Management | 1202 Annapolis Rd, Odenton, MD 21113-1397 | 2016-01-06 |
| 1215295027 | Kristen Lynn Davis | Social Worker | 1202 Annapolis Rd, Suite F, Odenton, MD 21113-1397 | 2012-04-30 |
| 1548429095 | John Evangelos Angelou | Dentist | 1202 Annapolis Rd, Suite A, Odenton, MD 21113-1397 | 2008-06-09 |
| 1447436241 | Whole Chiropractic Healthcare, LLC | Chiropractor | 1202 Annapolis Rd, Suite I, 2nd Flr, Odenton, MD 21113-1397 | 2008-01-11 |
| 1336340546 | Perryn Gutkowski | Counselor | 1202 Annapolis Rd, Suite F, Odenton, MD 21113-1387 | 2007-05-29 |
| 1275744757 | Vesta, Inc. | Community/Behavioral Health | 1202 Annapolis Rd, Suite F, Odenton, MD 21113-1387 | 2007-05-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366938599 | Dmv Community Health Services LLC | Clinic/Center | 87778 Pine Orchard Parkway, Odenton, MD 21113 | 2018-07-11 |
| 1285125997 | Edward Lashawn Harvey | Specialist | 207 Ammunition Ave, Odenton, MD 21113 | 2018-05-29 |
| 1275041394 | Aimee Kathleen Olivera Sanchez | Social Worker | 2150 Colonel Way, Odenton, MD 21113 | 2018-01-11 |
| 1891214714 | Bincy Kuttiplackal Mathai | Dentist | 1135 Annapolis Road, Odenton, MD 21113 | 2017-09-12 |
| 1730601949 | Amanda Mary Jackiewicz | Physician Assistant | Greater Maryland Pain Management, 1130 Annapolis Rd Suite 100, Odenton, MD 21113 | 2017-07-10 |
| 1346771235 | Pattrena Reid | Respiratory Therapist, Registered | 115 Bragg Blvd, Odenton, MD 21113 | 2017-03-23 |
| 1225572233 | Pamela Denise Ponder | Internal Medicine | 2603 Portola Court, Odenton, MD 21113 | 2016-12-09 |
| 1285052803 | Diana Nicole Spell | Internal Medicine | Johns Hopkins Community Physicians - Odenton, 1106 Annapolis Road, Odenton, MD 21113 | 2014-04-01 |
| 1730431321 | Orthopedic Physicians of Annapolis LLC | Prosthetic/Orthotic Supplier | 1106 Annapolis Road, Suite 130, Odenton, MD 21113 | 2012-10-08 |
| 1275869463 | Olubukola Fakunle | Pharmacist | 2294 Blue Water Blvd, Weis Pharmacy, Odenton, MD 21113 | 2009-10-23 |
| Find all providers in zip 21113 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003439431 | Robert A. Pascal Youth and Family Services, Inc. | Nurse Practitioner | 1226 Annapolis Rd, Odenton, MD 21113-1320 | 2020-05-20 |
| 1104122480 | Jp Clarke and Associates,llc | Nurse Practitioner | 8828 Telegraph Road, Suite A, Odenton, MD 21113-1130 | 2011-02-02 |
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| 1245839653 | Itoro Abatai | Nurse Practitioner | 9620 Maxwell Rd, Middle River, MD 21220-3792 | 2020-10-19 |
| 1992304372 | Catherine Koskei | Nurse Practitioner | 2295 Lowell Ridge Rd Apt B, Parkville, MD 21234-2370 | 2020-10-18 |
| 1194323857 | Meliora Davies | Nurse Practitioner | 206 Settlers Way, Upper Marlboro, MD 20774-5770 | 2020-10-14 |
| 1932707171 | David Mwangi | Nurse Practitioner | 27 Blue Spire Cir, Middle River, MD 21220-1743 | 2020-10-10 |
| 1750989042 | Osereme Nora Agboifo | Nurse Practitioner | 200 Ejoppa Rd Suite 106, Townson, MD 21286 | 2020-10-09 |
| 1639776446 | Serenity Heart Healthcare, LLC | Nurse Practitioner | 6755 Business Pkwy Ste 304, Elkridge, MD 21075-6740 | 2020-10-05 |
| 1689281529 | Premier Psychiatry, LLC | Nurse Practitioner | 10601 Virginia Ave, Cockeysville, MD 21030-2315 | 2020-09-24 |
| 1407462559 | Mem Scepter Home & Behavioral | Nurse Practitioner | 14104 Dawn Whistle Way, Bowie, MD 20721-1304 | 2020-09-23 |
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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.