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NPI Code Detail

MEDICARE: CHERYL A. SULLIVANT R. N. B.S.N.

MEDICARE: CHERYL A. SULLIVANT R. N. B.S.N.
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
1163WP0809XAdult Psychiatric/Mental Health Registered Nurse13-31706-102KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2100098080COTHERKSSED WAIVER

General Provider Information

NPI Number : 1922166735
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL A. SULLIVANT R. N. B.S.N.
Provider Business Mailing Address
First Line : 7840 WASHINGTON AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66112-2152
Country : US
Telephone Number : 913-328-4600
Fax Number :
Provider Business Practice Location Address
First Line : 7840 WASHINGTON AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66112-2152
Country : US
Telephone Number : 913-328-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2006
Last Update Date : 10/02/2008

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