MEDICARE: MRS. JANE MARY SULLIVAN PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	163877	MA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024182114	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	163877	OTHER	MA	RN

General Provider Information

NPI Number	:	1144490491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANE MARY SULLIVAN PMHNP-BC

Provider Business Mailing Address
First Line	:	1005 N GLEBE RD STE 525
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-5792
Country	:	US
Telephone Number	:	804-207-6737
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 N GLEBE RD STE 525
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-5792
Country	:	US
Telephone Number	:	804-207-6737
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2008
Last Update Date	:	07/20/2023

Similar Medicare Providers

1336372903 — HEALTHQARE SERVICES LLC
Practice Location Address:

1005 N GLEBE RD STE 230
ARLINGTON, VA
22201-5792

Practice Phone: 709-908-0800
Practice Fax: 703-908-0801

1629939772 — SEBASTIEN RICHARD SAINT-PIERRE LCSW
Practice Location Address:

1005 N GLEBE RD STE 525
ARLINGTON, VA
22201-5792

Practice Phone: 804-207-6737
Practice Fax:

1639208705 — MS. BRIDGETTE CHASE LPC, CAC
Practice Location Address:

1005 N GLEBE RD STE 525
ARLINGTON, VA
22201-5792

Practice Phone: 804-207-6737
Practice Fax:

1073789749 — DR. THOMAS CADE RAGGIO M.D.
Practice Location Address:

1005 N GLEBE RD STE 230
ARLINGTON, VA
22201-5792

Practice Phone: 571-500-8451
Practice Fax:

1447404942 — DR. MIRASLAVA KHMURETS M.D.
Practice Location Address:

1005 N GLEBE RD STE 525
ARLINGTON, VA
22201-5792

Practice Phone: 804-207-6737
Practice Fax:

1891940268 — ELISABETH V MORENO LCSW
Practice Location Address:

1005 N GLEBE RD STE 525
ARLINGTON, VA
22201-5792

Practice Phone: 804-207-6737
Practice Fax:

Directions to “ MRS. JANE MARY SULLIVAN PMHNP-BC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.