Leslie N. Sullivan, DNP, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3011711 Issued in KY

Practice address

1250 Keene Rd Ste 104
Nicholasville, KY 40356-7600

Phone

(859) 881-4288

NPI assigned

May 12, 2017

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

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1780111468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 11TH ST",
            "city": "NEWPORT",
            "state": "KY",
            "postal_code": "410712203",
            "telephone_number": "859-655-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 KEENE RD STE 104",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403567600",
            "telephone_number": "859-881-4288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 N Eagle Creek Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405091889",
            "country_code": "US",
            "telephone_number": "859-263-3888",
            "fax_number": "888-235-9895",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "830 S Limestone St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "40536",
            "country_code": "US",
            "telephone_number": "859-323-5511",
            "fax_number": "859-257-9816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LESLIE",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3011711",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "1094118",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100494780",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Nicholasville, KY
• Providers in Nicholasville, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.