Active NPI
Lisa Sullivan
- Community Health Registered Nurse
- Lake Charles, LA
National Provider Identifier
1750636783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Registered Nurse
- License
- RN109596
- Practice address
- 3236 Kirkman St
Lake Charles, LA 70601-8640 - Phone
- (337) 480-2627
- NPI assigned
- Jul 16, 2012
- Last updated
- Jul 16, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | RN109596 | LA | Primary |
Addresses
Primary practice location
3236 Kirkman St
Lake Charles, LA 70601-8640
Mailing address
6523 Sun Meadow LN
Lake Charles, LA 70605-0449
Phone (337) 478-9610
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN109596 | LA | MD | Community Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342396800000",
"number": "1750636783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6523 SUN MEADOW LN",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706050449",
"telephone_number": "337-478-9610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3236 KIRKMAN ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706018640",
"telephone_number": "337-480-2627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "LISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-16",
"last_updated": "2012-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "LA",
"license": "RN109596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.