MS. LISA RENEE SULLIVAN (NPI# 1811205750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811205750 |
| Entity Type | Individual |
| Full Name | MS. LISA RENEE SULLIVAN |
| Credential | PA-C |
| Practice Address |
44305 Harmony Ln Belleville MI 48111-2449 |
| Practice Telephone | 7347165588 |
| Mailing Telephone | 7347165588 |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2014-01-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601005958 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE LICENSE | 5601005958 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285282459 | Lisa Sullivan | Behavior Technician | 719 N Hillview Dr, Boise, ID 83712-8122 | 2019-08-29 |
| 1184183550 | Lisa Sullivan | Contractor | 113 Constitution Ct Apt A, Albany, GA 31721-2150 | 2019-03-15 |
| 1366875197 | Lisa Sullivan | Counselor | 3740 Colony Dr Ste 260, San Antonio, TX 78230-2233 | 2013-08-15 |
| 1336486414 | Lisa Marie Sullivan | Social Worker | 18 Rose Pl, Selden, NY 11784-3122 | 2013-01-10 |
| 1144579418 | Lisa Sullivan | Specialist | 252 California Ct, Mission Viejo, CA 92692-4098 | 2012-09-02 |
| 1700014065 | Lisa Hadeler Sullivan | Physical Therapist | 1420 Hwy 36, Hazlet, NJ 07730-1736 | 2009-06-25 |
| 1083874127 | Lisa Meghan Sullivan | Massage Therapist | 1640 Selby Ave Apt 6, Saint Paul, MN 55104-7379 | 2008-06-12 |
| 1841380375 | Lisa C. Sullivan | Pediatrics | 4950 Se Roethe Rd, Milwaukie, OR 97267-5746 | 2006-10-13 |
| 1386650273 | Lisa Marie Sullivan | Allergy & Immunology | 737 Saint Johns Ave, Highland Park, IL 60035-4650 | 2006-07-31 |
| 1023059813 | Lisa Hope Sullivan | Physical Therapist | 15 Neil Ct, Inside Jcc, Oceanside, NY 11572-5815 | 2006-06-10 |
| Street Address |
44305 HARMONY LN |
| City | BELLEVILLE |
| State | MI |
| Zip Code | 48111-2449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508406208 | Kimberly N Debusschere | Music Therapist | 4334 Dottie Ct., Belleville, MI 48111 | 2020-01-10 |
| 1083267041 | Kendalynn Ann Avant | Home Health | 49061 Denton Rd, Apt. 103, Belleville, MI 48111 | 2019-07-18 |
| 1073010864 | Shelly Lynn Milton | Massage Therapist | 9530 Rolan Meadows Drive, Belleville, MI 48111 | 2018-04-09 |
| 1053826040 | Helping Journey Counseling Service | Social Worker | 397 Main St Ste C, Belleville, MI 48111 | 2017-12-12 |
| 1447773254 | Advanced Counseling and Outreach | Counselor | 9513 Rolan Meadows Lane, Belleville, MI 48111 | 2017-07-24 |
| 1104348564 | Stella Adaku Amakeme | Nurse's Aide | 49007 Laguna Dr, Belleville, MI 48111 | 2017-07-07 |
| 1497285076 | Elizabeth Griffin | Recreation Therapist | 41460 W Archwood Dr, Apt A332, Belleville, MI 48111 | 2017-06-15 |
| 1831548122 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 41255 Coca Cola Dr., Belleville, MI 48111 | 2016-06-07 |
| 1639527187 | Wadler Fleurina | Physician Assistant | 11650 Belleville Rd #101, Belleville, MI 48111 | 2016-05-25 |
| 1922478080 | Mayia Raneese Chenault | Technician, Other | 48501 S I 94 Servce Dr Apt 107, Van Buren Twp, MI 48111 | 2015-10-01 |
| Find all providers in zip 48111 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548657059 | Joseph Shipman | Physician Assistant | 13604 Pinewood Ln, Belleville, MI 48111-2030 | 2015-04-22 |
| 1366433286 | Janet P. Rudderham | Physician Assistant | 311 W Lincoln St Ste 101, Belleville, IL 62220-1902 | 2005-10-31 |
| 1396375788 | Emily Jean Sloan | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-01-24 |
| 1639678451 | Allyson Leigh Peludat | Physician Assistant | 4600 Memorial Dr Ste W3, Belleville, IL 62226-5359 | 2018-02-07 |
| 1689188765 | Hill & Desire Healthcare Pllc | Physician Assistant | 25 Owen St, Belleville, MI 48111-2921 | 2017-11-28 |
| 1881138576 | Kathryn Elizabeth Markferding | Physician Assistant | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2016-12-14 |
| 1427458454 | Jenny Kalina | Physician Assistant | 5 Franklin Ave, Belleville, NJ 07109-3532 | 2014-08-27 |
| 1013352558 | Lucknie Ovincy | Physician Assistant | 50 Newark Ave, Belleville, NJ 07109-1185 | 2013-05-09 |
| 1417203928 | Bhargavi Jitendra Patel | Physician Assistant | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2012-08-02 |
| 1437275252 | Nancy C Braddock | Physician Assistant | 311 W Lincoln St, Ste 201, Belleville, IL 62220-1902 | 2007-03-22 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 48111 |
Please comment or provide details below to improve the information on MS. LISA RENEE 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.