Melissa Sullivan, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

220313 Issued in LA

Practice address

1809 Northpointe LN Ste 102
Ruston, LA 71270-3852

Phone

(318) 255-3762

Fax

(318) 255-2866

NPI assigned

Jun 7, 2021

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

State licenses

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1376110676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705941",
            "telephone_number": "318-255-3690",
            "fax_number": "318-251-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 NORTHPOINTE LN STE 102",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712703852",
            "telephone_number": "318-255-3762",
            "fax_number": "318-255-2866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 S Farmerville St",
            "address_purpose": "LOCATION",
            "city": "Ruston",
            "state": "LA",
            "postal_code": "712705941",
            "country_code": "US",
            "telephone_number": "318-255-3690",
            "fax_number": "318-251-6116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MELISSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "220313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaelyn Straughter
• Gregory Allen Strickland Jr., CRNA
• Stronger Minds Therapy LLC
• Patrick Stuckey, D.D.S.
• Rebecca Meier Stutzman, LCSW-BACS
• Wanda J Sullivan, RN
• Whitney Sumlin
• Brooke Nichole Sutton, NP
• Dustin Swafford
• SWC Ruston, LLC

• All providers in Ruston, LA
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.