Lorraine Louise Sullivan, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

CNP81643 Issued in ME

Practice address

1577 Congress St
1St Floor
Portland, ME 04102-2169

Phone

(207) 662-1442

Fax

(207) 775-2467

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1467548578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301C US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749701",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 CONGRESS ST",
            "address_2": "1ST FLOOR",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022169",
            "telephone_number": "207-662-1442",
            "fax_number": "207-775-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LORRAINE",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ME",
            "license": "R016719",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ME",
            "license": "CNP81643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263670099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Sullivan, LCPC
• Kara Sullivan
• Karli Sullivan, PA
• Kathleen K Sullivan, LMFT
• Kevin George Sullivan, M.D.
• Maura Corcoran Sullivan, PSY.D.
• Michael P Sullivan, MD
• William M Sullivan, M.D.
• Jennie S Summers-Shea, LCPC
• Sun Valley Plus LLC

• Pediatric Nurse Practitioner in Portland, ME
• Providers in Portland, ME by specialty
• Pediatric Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; 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.