MRS. TARA ROBERTA SULLIVAN (NPI# 1841814456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841814456 |
| Entity Type | Individual |
| Full Name | MRS. TARA ROBERTA SULLIVAN |
| Credential | RN,IBCLC,LCCE |
| Practice Address |
24808 Boston St Dearborn MI 48124-4411 |
| Practice Telephone | 3136184206 |
| Mailing Telephone | 3136184206 |
| Enumeration Date | 2020-05-31 |
| Last Update Date | 2020-05-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WL0100X |
Registered Nurse Specialization: Lactation Consultant |
4704245099 | MI | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205199601 | Tara Marie Sullivan | Specialist | 14911 12th Ave, Whitestone, NY 11357-1725 | 2012-06-20 |
| 1023202363 | Tara Marie Sullivan | Dentist | 1203 E Pine St, Seattle, WA 98122-3921 | 2007-08-29 |
| 1518410133 | Tara L. Sullivan | Optometrist | 245 Center St, Auburn, ME 04210-6169 | 2016-07-31 |
| 1902853104 | Tara Sullivan | Anesthesiology | 6501 Coyle Ave, Carmichael, CA 95608 | 2006-05-31 |
| Street Address |
24808 BOSTON ST |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-4411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
| 1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
| 1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
| 1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
| 1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
| 1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
| 1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
| Find all providers in zip 48124 | ||||
| Taxonomy Code | 163WL0100X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Lactation Consultant |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386119477 | Lisa Marie Levy | Registered Nurse | 520 N Silvery Ln, Dearborn, MI 48128-1538 | 2018-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851183 | Cynthia Jean Werner | Registered Nurse | 70067 Beach Dr, Edwardsburg, MI 49112-8434 | 2020-11-07 |
| 1790392959 | Theresa Hope Madoun | Registered Nurse | 3362 Parkland Dr, West Bloomfield, MI 48322-1828 | 2020-09-30 |
| 1609491133 | Rebecca Shanahan | Registered Nurse | 3489 W River Rd, Muskegon, MI 49445-9606 | 2020-06-10 |
| 1861031957 | Rebecca Taylor | Registered Nurse | 3150 Livernois Rd Ste 175, Troy, MI 48083-5058 | 2020-01-06 |
| 1275174484 | Micia Jena Eddins | Registered Nurse | 4217 Aretha Ave, Detroit, MI 48201-1556 | 2019-09-30 |
| 1790248854 | Lactation Home Support LLC | Registered Nurse | 1218 S Forest Dr, Muskegon, MI 49442-4814 | 2019-04-07 |
| 1932680717 | Barbara Danielle Demske | Registered Nurse | 269 Roland St, Belleville, MI 48111-2742 | 2018-08-28 |
| 1053800649 | Leontine Wallace | Registered Nurse | 2300 Haggerty Rd Ste 2110, West Bloomfield, MI 48323-2191 | 2018-05-09 |
| 1588162200 | Linda Kay Gewirtz | Registered Nurse | 223 E Clinton St, Ovid, MI 48866-9704 | 2018-01-28 |
| 1679096374 | Rebecca Campau | Registered Nurse | 4985 Lakeshore Rd, Fort Gratiot, MI 48059 | 2017-07-25 |
| 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.