KELLY SULLIVAN CRNP NPI 1114392735

NPI Information

  • NPI: 1114392735
  • Provider Name: KELLY SULLIVAN, CRNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2 W CRESCENT PARK
    WARREN, PA
    ZIP 16365
  • Phone: (814) 723-3300

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NPI Details

Kelly Sullivan, CRNP is a family nurse practitioner in Warren, PA. Kelly Sullivan, CRNP NPI is 1114392735. 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:

2 W CRESCENT PARK
WARREN, PA
ZIP 16365-111
Phone: (814) 723-3300
Fax: (814) 726-9412

The NPI 1114392735 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Follow-up hospital inpatient care per day, typically 15 minutes (HCPCS:99231)

The enumeration date for this NPI number is 12/8/2015 and was last updated on 10/3/2018.

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
1364SF0001XClinical Nurse SpecialistFamily HealthSP015625PENNSYLVANIANo
2363LF0000XNurse PractitionerFamilySP015625PENNSYLVANIAYes

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: 11/21/2025

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