MS. CHRISTINE ANN SULLIVAN CNM FNP PHD MSN NPI 1265424121

NPI Information

NPI: 1265424121
Provider Name: MS. CHRISTINE ANN SULLIVAN, CNM, FNP, PHD, MSN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
34800 BOB WILSON DR
BLDG 6 5TH FLOOR CREDENTIALING
SAN DIEGO, CA
ZIP 92134
Phone: (619) 532-6471
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MS. Christine Ann Sullivan, CNM, FNP, PHD, MSN is a family nurse practitioner in San Diego, CA with 26 years of experience. MS. Christine Ann Sullivan, CNM, FNP, PHD, MSN NPI is 1265424121. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

34800 BOB WILSON DR
BLDG 6 5TH FLOOR CREDENTIALING
SAN DIEGO, CA
ZIP 92134-000
Phone: (619) 532-6471

The NPI 1265424121 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 8/17/2005 and was last updated on 3/10/2015.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WW0101X	Registered Nurse	Women's Health Care, Ambulatory	393917	CALIFORNIA	No
2	367A00000X	Advanced Practice Midwife		548	CALIFORNIA	No
3	363LF0000X	Nurse Practitioner	Family	13187	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CX971Z	MEDICARE PIN	CALIFORNIA
2	CX971Y	MEDICARE PIN	CALIFORNIA

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

NPI Synchronization or Removal

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