Elizabeth Theresa Sullivan, CNS

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

RN304635L Issued in PA

Practice address

3400 Civic Center Blvd
4 West
Philadelphia, PA 19104

Phone

(215) 662-2300

Fax

(215) 614-0418

NPI assigned

May 8, 2018

Sex

Female

Sole proprietor

No

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

Credentials

Certified Nurse Specialist

State licenses

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1871082636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "4 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-662-2300",
            "fax_number": "215-614-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "4 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-2300",
            "fax_number": "215-614-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ELIZABETH",
        "middle_name": "THERESA",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "PA",
            "license": "RN304635L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Sullivan
• Christine Sullivan, DOULA
• Colleen Rebekah Sullivan
• Dana Marie Sullivan, M.A., BCBA
• Danielle Sullivan, LCSW
• Erin Kelly Sullivan, CRNP
• Gail T Sullivan, MD
• Hannah Catherine Sullivan, MD
• Julianna Sullivan, CCC-SLP
• Karman Sullivan

• Diabetes Educator Registered Nurse in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Diabetes Educator Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.