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DR. TIYIKA JANAYE SULLIVAN NURSE PRACTITIONER NPI 1063803740


NPI Information

NPI: 1063803740
Provider Name: DR. TIYIKA JANAYE SULLIVAN, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
4692 BROWNSBORO RD
WINSTON SALEM, NC
ZIP 27106
Phone: (336) 251-1114
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DR. Tiyika Janaye Sullivan, NURSE PRACTITIONER is an adult health nurse practitioner in Winston Salem, NC with 11 years of experience. DR. Tiyika Janaye Sullivan, NURSE PRACTITIONER NPI is 1063803740. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduation Year:2013

The provider's business location address is:

4692 BROWNSBORO RD
WINSTON SALEM, NC
ZIP 27106-410
Phone: (336) 251-1114
Fax: (336) 251-1115

The NPI 1063803740 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/17/2015 and was last updated on 10/13/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LA2200XNurse PractitionerAdult Health5007480NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.