SUSAN M SULLIVAN (NPI# 1679900757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679900757 |
| Entity Type | Individual |
| Full Name | SUSAN M SULLIVAN |
| Other Name | SUSAN M O'NEIL |
| Credential | FNP |
| Practice Address |
621 S New Ballas Rd Ste 228a Saint Louis MO 63141-8256 |
| Practice Telephone | 3142514966 |
| Practice Fax Number | 3142514588 |
| Mailing Telephone | 3142514966 |
| Mailing Fax Number | 3142514588 |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2020-08-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
2013039392 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124382700 | Susan M Sullivan | Massage Therapist | 8655 Main St, Williamsville, NY 14221-7501 | 2012-06-28 |
| 1598031999 | Susan Kathleen Sullivan | Case Manager/Care Coordinator | 3123 Catrina Ln, Annapolis, MD 21403-4340 | 2012-03-29 |
| 1760755524 | Susan Griffin Sullivan | Counselor | 672 Wyndham Crossings Cir, Des Peres, MO 63131-2149 | 2012-02-09 |
| 1871882761 | Susan Lea Sullivan | Lactation Consultant, Non-RN | 6421 Lakewind Cir, Parker, CO 80134 | 2011-03-31 |
| 1366758286 | Susan Carol Sullivan | Marriage & Family Therapist | 4760 Sepulveda Boulevard, Culver City, CA 90230-4820 | 2010-08-30 |
| 1861698144 | Susan Huber Sullivan | Counselor | 407 W Warren St, Shelby, NC 28150-5329 | 2007-06-25 |
| 1427171214 | Susan Emma Sullivan | Developmental Therapist | 210 South Market, Bondville, IL 61815-0133 | 2007-04-09 |
| 1144359746 | Susan B Sullivan | Pharmacist | 9501 E Shea Blvd # Mc139, Scottsdale, AZ 85260-6719 | 2007-03-02 |
| 1144315607 | Susan Elizabeth Sullivan | Psychologist | 13 Welby Road, Suite 2, New Bedford, MA 02745-1132 | 2006-10-03 |
| 1407457641 | Susan Michele Sullivan | Pharmacist | 1600 W Main St, Walnut Ridge, AR 72476-9401 | 2020-11-04 |
| Street Address |
621 S NEW BALLAS RD STE 228A |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-8256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619285 | Jennifer Lee Speiser | Nurse Practitioner | 12545 Olive Blvd, Saint Louis, MO 63141-6311 | 2020-11-04 |
| 1265045264 | Andrea Jane Montgomery | Nurse Practitioner | 444 Honeysuckle Ln, Saint Louis, MO 63119-4521 | 2020-08-28 |
| 1396362224 | Erin M Kehoe | Nurse Practitioner | 12973 Olive Blvd, Saint Louis, MO 63141-6149 | 2020-06-26 |
| 1508482506 | Matthew Dale Tieskoetter | Nurse Practitioner | 333 S Kirkwood Rd Ste 203, Saint Louis, MO 63122-6161 | 2020-06-25 |
| 1861033615 | Benedicta Esi | Nurse Practitioner | 6024 Pennsylvania Ave, Saint Louis, MO 63111-2555 | 2019-10-02 |
| 1245896893 | Katina D Smith | Nurse Practitioner | 8820 Mcnulty Dr, Saint Louis, MO 63114-4146 | 2019-05-18 |
| 1912413584 | Lucija Kozul Sadl | Nurse Practitioner | 3525 Forest Dale Dr, Saint Louis, MO 63125-4212 | 2017-12-19 |
| 1275071326 | Kathryn Ries | Nurse Practitioner | 3535 South Broadway, Suite 118, Saint Louis, MO 63118-3907 | 2017-02-09 |
| 1144775966 | Hienok Hailu | Nurse Practitioner | 11725 Casa Grande Dr, Saint Louis, MO 63146-4223 | 2016-08-22 |
| 1992167522 | Lanyn Clark | Nurse Practitioner | 40 Ladue Ter, Saint Louis, MO 63124-2048 | 2016-03-23 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
Please comment or provide details below to improve the information on SUSAN M 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.