AMANDA MICHELLE SULLIVAN ARNP NPI 1578900056

NPI Information

NPI: 1578900056
Provider Name: AMANDA MICHELLE SULLIVAN, ARNP
Classification: Nurse Practitioner - 363LN0000X
Entity Type: Individual

Specialization: Neonatal

PECOS Registration: Yes

Address:
655 W 8TH ST
UFJAX - DEPT. OF PEDIATRICS/NEONATOLOGY
JACKSONVILLE, FL
ZIP 32209
Phone: (904) 244-5100
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Amanda Michelle Sullivan, ARNP is a neonatal nurse practitioner in Jacksonville, FL. Amanda Michelle Sullivan, ARNP NPI is 1578900056. 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:

655 W 8TH ST
UFJAX - DEPT. OF PEDIATRICS/NEONATOLOGY
JACKSONVILLE, FL
ZIP 32209-511
Phone: (904) 244-5100
Fax: (904) 244-4301

The NPI 1578900056 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 5/24/2013 and was last updated on 12/2/2014.

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	363LN0000X	Nurse Practitioner	Neonatal	ARNP9353428	FLORIDA	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
1	HH265Z	MEDICARE PIN	FLORIDA
2	003135006B	MEDICAID	GEORGIA
3	008891500	MEDICAID	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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