BETHANY S. SULLIVAN APRN NPI 1962740969

NPI Information

  • NPI: 1962740969
  • Provider Name: BETHANY S. SULLIVAN, APRN
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4851 KY ROUTE 321
    PRESTONSBURG, KY
    ZIP 41653
  • Phone: (606) 886-1173

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NPI Details

Bethany S. Sullivan, APRN is a family nurse practitioner in Prestonsburg, KY with 13 years of experience. Bethany S. Sullivan, APRN NPI is 1962740969. 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:

4851 KY ROUTE 321
PRESTONSBURG, KY
ZIP 41653-113
Phone: (606) 886-1173
Fax: (606) 886-2193

The NPI 1962740969 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 1/25/2013 and was last updated on 8/16/2017.

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
1363LF0000XNurse PractitionerFamily3007834KENTUCKYYes

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
17100229990MEDICAIDKENTUCKY

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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