Dana R Sullivan, MSN, RN, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN01627 Issued in RI

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 444-6680

NPI assigned

Oct 7, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689124109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WHIPPLE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029083258",
            "telephone_number": "401-854-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-6680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "152 Oxbow Rd",
            "address_purpose": "LOCATION",
            "city": "Wayland",
            "state": "MA",
            "postal_code": "017781028",
            "country_code": "US",
            "telephone_number": "508-397-7181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DANA",
        "middle_name": "R",
        "credential": "MSN, RN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "1170573",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "20162082",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "RI",
            "license": "APRN01627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Ihn Suh, MD
• Abigail Sullivan
• Allison Sullivan, LMHC, LCDP
• Amanda Sullivan
• Catherine B. Sullivan, M.D.
• Edward John Sullivan, RPH
• Elizabeth L Sullivan, M.D.
• Elizabeth Marie Sullivan
• Helen Mary Sullivan, R.N.
• James C Sullivan, MD

• Pediatric Nurse Practitioner in Providence, RI
• Providers in Providence, RI by specialty
• Pediatric Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.