MS. NANCY CARLA SULLIVAN (NPI# 1700135910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700135910 |
| Entity Type | Individual |
| Full Name | MS. NANCY CARLA SULLIVAN |
| Credential | LPN |
| Practice Address |
2000 Domanik Dr Racine WI 53404-2910 |
| Practice Telephone | 2626334800 |
| Practice Fax Number | 2626335999 |
| Mailing Telephone | 2626334800 |
| Mailing Fax Number | 2626335999 |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2012-09-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 134413 | WI | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215952759 | Nancy Elizabeth Sullivan | Clinical Neuropsychologist | 2555 Park Blvd, Suite 20, Palo Alto, CA 94306-1924 | 2006-07-13 |
| 1316930282 | Nancy Jane Sullivan | Social Worker | 1800 Cooper Point Rd Sw, Building 24b, Olympia, WA 98502-1178 | 2005-08-25 |
| 1578967394 | Nancy Leefong-chang Sullivan | Nurse Practitioner | 1105 S 348th St Ste B103, Federal Way, WA 98003-7027 | 2014-10-22 |
| 1902146715 | Nancy Peters Sullivan | Nurse Practitioner | 87 Paine Mountain Dr, Northfield, VT 05663-5791 | 2013-02-15 |
| 1437471778 | Nancy J Sullivan | Registered Nurse | 1323 W Prince Rd, Tucson, AZ 85705-3114 | 2010-02-26 |
| 1710114376 | Nancy Marie Sullivan | Anesthesiology | 4200 University Ave Ste 300, West Des Moines, IA 50266-5945 | 2009-06-22 |
| 1619112828 | Nancy Anne Sullivan | Social Worker | 9729 64th Rd, Rego Park, NY 11374-2240 | 2008-12-03 |
| 1457504433 | Nancy L. Sullivan | Nurse Practitioner | 12720 Mcmanus Blvd, Suite 311, Newport News, VA 23602-4414 | 2008-11-04 |
| 1033321138 | Nancy Sullivan | Registered Nurse | 1221 Fulton Mall, Fresno, CA 93721-1915 | 2007-05-03 |
| 1801010434 | Nancy E. Sullivan | Counselor | 586 Merrimack St, Lowell, MA 01854-3944 | 2007-04-13 |
| Street Address |
2000 DOMANIK DR |
| City | RACINE |
| State | WI |
| Zip Code | 53404-2910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821345455 | Derek Quella | Registered Nurse | 2000 Domanik Dr, Racine, WI 53404-2910 | 2012-08-14 |
| 1679917728 | Kelley Cooper | Registered Nurse | 2000 Domanik Dr, Racine, WI 53404-2910 | 2013-04-19 |
| 1104175694 | Kizzie Marie Durgom | Registered Nurse | 2000 Domanik Dr, Racine, WI 53404-2910 | 2012-08-30 |
| 1376891903 | Janet Ann Shimkus | Social Worker | 2000 Domanik Dr, Racine, WI 53404-2910 | 2012-08-29 |
| 1356699128 | Dennis Norman Voll | Social Worker | 2000 Domanik Dr, Racine, WI 53404-2910 | 2012-08-27 |
| 1508114075 | Barbara Talaska | Licensed Practical Nurse | 2000 Domanik Dr, Racine, WI 53404-2910 | 2012-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033686001 | Rosamaria E Garcia | Registered Nurse | 1120 Hartman Ct, Racine, WI 53404 | 2018-10-29 |
| 1912372418 | Avada Audiology and Hearing Care | Preferred Provider Organization | 813 Fox Lane Suite B, Waterford, WI 53404 | 2015-12-09 |
| 1215095096 | Bonnie Lee Wirfs | Internal Medicine | 2000 Domanik Drive, Racine, WI 53404 | 2006-12-05 |
| 1992813893 | Craig E Fleury | Dentist | 7117 Green Bay Road, Racine, WI 53404 | 2006-08-29 |
| 1174631089 | Greg L Smart | Dentist | 7117 Green Bay Road, Racine, WI 53404 | 2006-08-29 |
| 1871953950 | Amybeth Mahoney | Counselor | 4726 N Green Bay Rd, Racine, WI 53404-1108 | 2016-03-02 |
| 1649560871 | Abby Healthcare Staffing, LLC | Home Health | 3406 Killips Ln, Racine, WI 53404-1310 | 2011-04-08 |
| 1114071917 | Ib Thostrup | Chiropractor | 2827 Rapids Dr, Racine, WI 53404-1620 | 2007-01-22 |
| 1417001140 | Thostrup Chiropractic, S.c. | Chiropractor | 2827 Rapids Dr, Racine, WI 53404-1620 | 2007-01-22 |
| 1578620423 | Sally Jean Brown | Chiropractor | 2609 Rapids Dr, Racine, WI 53404-1741 | 2007-01-02 |
| Find all providers in zip 53404 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457966731 | Denise Brown | Licensed Practical Nurse | 1215 Monroe Ave, Racine, WI 53405-2862 | 2020-09-13 |
| 1194294850 | Stephanie Angel Compton | Licensed Practical Nurse | 815 8th St Apt 214, Racine, WI 53403-1496 | 2018-11-24 |
| 1790276889 | Catalina Fransisca Nuno | Licensed Practical Nurse | 811 Forest St, Racine, WI 53404-3257 | 2018-05-23 |
| 1649796087 | Cara Jerdee | Licensed Practical Nurse | 1423 William St, Racine, WI 53402-4161 | 2017-08-17 |
| 1710359427 | Doris Mitchell | Licensed Practical Nurse | 1322 Buchanan St, Racine, WI 53402-5014 | 2015-10-21 |
| 1194134130 | Corine Baumstark | Licensed Practical Nurse | 1903 English St, Racine, WI 53404-2360 | 2014-08-04 |
| 1851725972 | Marguerite Emily Macdonald | Licensed Practical Nurse | 5215 Willowview Rd, Racine, WI 53402-2257 | 2013-08-26 |
| 1720411861 | Jennifer Jane Lagore | Licensed Practical Nurse | 50250 Hoback Rd, Racine, OH 45771-9751 | 2013-08-13 |
| 1346587987 | Emily Manago Reisman | Licensed Practical Nurse | 111 Sheffield Dr, Racine, WI 53402-3638 | 2013-01-15 |
| 1689922254 | Renee Corinne Crum | Licensed Practical Nurse | 1435 Ohio St, Racine, WI 53405 | 2012-08-29 |
| Find all providers in RACINE | ||||
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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.