Mariah Sullivan, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

577174 Issued in NY

Practice address

6537 Johnson Rd
Glenfield, NY 13343-4120

Phone

(315) 571-4016

NPI assigned

Apr 1, 2026

Last updated

Apr 1, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1775001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1053252551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 THAYER HILL RD",
            "city": "BOONVILLE",
            "state": "NY",
            "postal_code": "133091807",
            "telephone_number": "315-571-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6537 JOHNSON RD",
            "city": "GLENFIELD",
            "state": "NY",
            "postal_code": "133434120",
            "telephone_number": "315-571-4016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1738 Thayer Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Boonville",
            "state": "NY",
            "postal_code": "133091807",
            "country_code": "US",
            "telephone_number": "315-571-4016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARIAH",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-01",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "577174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Leigh Kloster
• Kylie Kloster
• Jaclyne Elizabeth Newton, LMHC
• Mary Gay Skiff, LPN
• Melinda Staie, LPN
• Charity Lynn Trainham, MSW INTERN
• Margaret Ann Wheadon, LMT
• Lynne T Worden, RN

• General Practice Registered Nurse in Glenfield, NY
• Providers in Glenfield, NY by specialty
• General Practice Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.