Michelle Elaine Sultage, CRNP-FAMILY

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R161602 Issued in MD

Practice address

28105 Three Notch Rd
1C
Mechanicsville, MD 20659-3235

Phone

(301) 290-1510

NPI assigned

Mar 22, 2011

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429401600000",
    "number": "1093014656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28105 THREE NOTCH RD",
            "address_2": "1C",
            "city": "MECHANICSVILLE",
            "state": "MD",
            "postal_code": "206593235",
            "telephone_number": "301-290-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28105 THREE NOTCH RD",
            "address_2": "1C",
            "city": "MECHANICSVILLE",
            "state": "MD",
            "postal_code": "206593235",
            "telephone_number": "301-290-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTAGE",
        "first_name": "MICHELLE",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "CRNP-FAMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2015-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R161602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Maryland Center for Independent Living
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• St. Mary'S County Health Department
• St. Mary'S County Health Department
• St. Mary'S County Health Department
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• Bryant Pinklon Thomas, PT
• Elizabeth Dickens Turner, MPT

• Family Nurse Practitioner in Mechanicsville, MD
• Providers in Mechanicsville, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2015; 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.