MS. PAMELA SUE SULLIVAN GNP NPI 1336267699

NPI Information

  • NPI: 1336267699
  • Provider Name: MS. PAMELA SUE SULLIVAN, GNP
  • Classification: Nurse Practitioner - 363LG0600X
  • Specialization: Gerontology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 40055 BOB HOPE DR STE B
    RANCHO MIRAGE, CA
    ZIP 92270
  • Phone: (760) 202-3946

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NPI Details

MS. Pamela Sue Sullivan, GNP is a gerontology nurse practitioner in Rancho Mirage, CA. MS. Pamela Sue Sullivan, GNP NPI is 1336267699. 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:

40055 BOB HOPE DR STE B
RANCHO MIRAGE, CA
ZIP 92270-940
Phone: (760) 202-3946
Fax: (760) 770-4392

The NPI 1336267699 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 3/26/2007 and was last updated on 7/21/2022.

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
1163WG0600XRegistered NurseGerontology262478CALIFORNIANo
2363LG0600XNurse PractitionerGerontology12764CALIFORNIAYes

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
11409819OTHERCALIFORNIACIGNA
24984336OTHERCALIFORNIAAETNA

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

NPI Synchronization or Removal

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