Jessica Sullivan, CRNP, DNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1-162940 Issued in AL

Practice address

4330 Highway 78 E Ste 114
Jasper, AL 35501-8955

Phone

(205) 512-1122

NPI assigned

Nov 9, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1573257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1841835238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 MATTHEWS DR",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355036052",
            "telephone_number": "205-544-5663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 HIGHWAY 78 E STE 114",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355018955",
            "telephone_number": "205-512-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JESSICA",
        "credential": "CRNP, DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-09",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-162940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Nurse Practitioner in Jasper, AL
• Providers in Jasper, AL by specialty
• Pediatric Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; 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.