Kathleen Lea Sullivan, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4478 Issued in CT

Practice address

134 Grandview Ave
208
Waterbury, CT 06708-2507

Phone

(203) 755-3279

Fax

(203) 755-3057

NPI assigned

Sep 9, 2010

Last updated

Jul 24, 2026By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Connecticut Neurodevelopmental Services

  • Neurology with Special Qualifications in Child Neurology Physician
  • Waterbury, CT
  • NPI 1467527580

  Family

  NPD (past)
• Seasons Hospice & Palliative Care of Connecticut, LLC

  dba AccentCare Hospice & Palliative Care of Connecticut

  • Community Based Hospice Care Agency
  • Middlebury, CT
  • NPI 1669726477
  NPD (past)
• Willow and Oak Wellness, LLC

  • Clinical Social Worker
  • Newtown, CT
  • NPI 1740948918
  NPD (past)

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1811204985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 GRANDVIEW AVE STE 208",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082507",
            "fax_number": "203-755-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 GRANDVIEW AVE",
            "address_2": "208",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082507",
            "telephone_number": "203-755-3279",
            "fax_number": "203-755-3057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 S Main St Ste 110B",
            "address_purpose": "LOCATION",
            "city": "Newtown",
            "state": "CT",
            "postal_code": "064705313",
            "country_code": "US",
            "telephone_number": "203-770-5963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KATHLEEN",
        "middle_name": "LEA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "4478",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "004478",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie L. Sugin, M.D.
• Hajrie Sulejmani
• Elizabeth Sullivan-Well
• Anna Sullivan, APRN
• Jacqueline A Sullivan, MSW
• Lindsey Ann Sullivan, MSW,BA
• Meghan Sullivan, RD
• Veronica Sullivan
• William Summa
• Gertrude Ellen Super, M.A.

• Family Nurse Practitioner in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.