ICEL SULLIVAN (NPI# 1770116436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770116436 |
| Entity Type | Individual |
| Full Name | ICEL SULLIVAN |
| Credential | ARNP |
| Practice Address |
1911 Cooks Hill Rd Centralia WA 98531-9073 |
| Practice Telephone | 3607366778 |
| Mailing Telephone | 3607366778 |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2020-05-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN00164194 | WA | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP61060250 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1911 COOKS HILL RD |
| City | CENTRALIA |
| State | WA |
| Zip Code | 98531-9073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003891714 | Trisha Kay Bender | Psychiatry & Neurology | 1911 Cooks Hill Rd, Centralia, WA 98531 | 2005-12-14 |
| 1083132161 | Therese Henry | Nurse Practitioner | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2017-09-08 |
| 1891215182 | N W Pediatric Center, Inc. P.s. | Case Manager/Care Coordinator | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2017-06-27 |
| 1124557715 | Margie Nielsen | Nurse Practitioner | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2017-06-07 |
| 1700270295 | Heather Anne Powell | Dietitian, Registered | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2015-03-24 |
| 1952736019 | Rebekah Brooke Miner | Nurse Practitioner | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2013-09-09 |
| 1851649198 | Katherine Teresa Kehoe | Nurse Practitioner | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2012-08-16 |
| 1649540345 | Lindsay Paige Bullock | Dietitian, Registered | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2012-01-11 |
| 1477789956 | Northwest Pediatric Center, Inc. P.s. | Pediatrics | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2009-06-10 |
| 1184899296 | Bethany Anne Krieger | Nurse Practitioner | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2008-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306462205 | Jelisa Renae Thomas | Counselor | 3510 Steelhammer Ln, Centralia, WA 98531 | 2020-06-17 |
| 1205498607 | Jennifer Kristine Mcglynn Paterno | Counselor | 2428 W. Reynods Ave, Centralia, WA 98531 | 2019-07-05 |
| 1538646328 | Adam Jeffrey Moore | Counselor | 3510 Steelhammer Lane, Centralia, WA 98531 | 2018-07-24 |
| 1144706698 | Euijeong Kim | Occupational Therapist | Rehabilitation Therapies, 914 S. Scheuber Rd, Centralia, WA 98531 | 2018-07-18 |
| 1104315266 | Margaret Fowler Floyd | Registered Nurse | Centralia High School, 813 Eshom Road, Centralia, WA 98531 | 2018-05-04 |
| 1124545777 | Samantha Michelle Moody | Speech-Language Pathologist | Centralia School District, 2320 Borst Ave, Centralia, WA 98531 | 2017-08-24 |
| 1821520289 | Alexa Franks | Behavior Technician | 2428 West Reynolds Ave., Centralia, WA 98531 | 2017-04-03 |
| 1023559861 | Brandy Michelle Peterson | Counselor | 135 W. Main Steet, Centralia, WA 98531 | 2017-03-13 |
| 1841738812 | Graceful Healing Naturopathic | Naturopath | 219 N Tower Ave, Suite 304, Centralia, WA 98531 | 2017-02-09 |
| 1043681513 | Angela Naillon | Counselor | 2428 West Reynolds, Centralia, WA 98531 | 2015-10-09 |
| Find all providers in zip 98531 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083132161 | Therese Henry | Nurse Practitioner | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2017-09-08 |
| 1124557715 | Margie Nielsen | Nurse Practitioner | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2017-06-07 |
| 1952736019 | Rebekah Brooke Miner | Nurse Practitioner | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2013-09-09 |
| 1851649198 | Katherine Teresa Kehoe | Nurse Practitioner | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2012-08-16 |
| 1184899296 | Bethany Anne Krieger | Nurse Practitioner | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2008-04-29 |
| 1336127299 | Sarah C Spencer | Nurse Practitioner | 1911 Cooks Hill Rd, Centralia, WA 98531-9073 | 2006-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881200509 | Megan Maureen Bauer | Nurse Practitioner | 6057 California Ave Sw, Seattle, WA 98136-1612 | 2020-09-17 |
| 1265077960 | Hannah Thornton | Nurse Practitioner | 4800 Sand Point Way Ne # Fa.2114, Seattle, WA 98105-3901 | 2019-11-17 |
| 1598319683 | Jennifer Lynn Bryson | Nurse Practitioner | 8738 Falls Ave Se, Snoqualmie, WA 98065-9610 | 2019-07-28 |
| 1013494434 | Lindsay Bascom Brown | Nurse Practitioner | 12815 120th Ave Ne Ste A, Kirkland, WA 98034-3003 | 2018-07-27 |
| 1518475631 | Sarah Remorca Agtarap | Nurse Practitioner | 175 1st Pl Nw Ste A, Issaquah, WA 98027-2746 | 2018-01-11 |
| 1518470137 | Bear Creek Pediatrics | Nurse Practitioner | 105 W 8th Ave Ste 7035, Spokane, WA 99204-2313 | 2017-11-06 |
| 1871005298 | Alexis Anne Abel | Nurse Practitioner | 15650 Ne 24th St Ste C, Bellevue, WA 98008-2460 | 2017-10-25 |
| 1326569021 | Spencer Rorie Crihfield | Nurse Practitioner | Po Box 1452, Pasco, WA 99301-1223 | 2017-07-03 |
| 1912427386 | Melinda Ehren Kratzig | Nurse Practitioner | 4800 Sand Point Way Ne # Msoa9220, Seattle, WA 98105-3901 | 2017-06-26 |
| 1245766880 | Jennifer Jean Baker | Nurse Practitioner | 904 7th Ave Fl 3, Seattle, WA 98104-1132 | 2017-05-02 |
| 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.