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NPI Code Detail

MEDICARE: PAIGE ANN SULLIVAN PMHNP-BC

MEDICARE: PAIGE ANN 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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner858292TX
2363LP0808XPsychiatric/Mental Health Nurse Practitioner183298AK

General Provider Information

NPI Number : 1982051728
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAIGE ANN SULLIVAN PMHNP-BC
Provider Business Mailing Address
First Line : 7033 E TUDOR RD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-1262
Country : US
Telephone Number : 907-729-8901
Fax Number : 907-729-6353
Provider Business Practice Location Address
First Line : 400 W BENSON BLVD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-3829
Country : US
Telephone Number : 907-729-5418
Fax Number : 907-729-8607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2016
Last Update Date : 11/02/2023

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Directions to “ PAIGE ANN SULLIVAN PMHNP-BC” Practice Location

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