LAVERNE A SULLIVAN RD
NPI 1023045200
Dietitian, Registered in Fort Wayne, IN

Q: What is Laverne Sullivan's NPI number?

The NPI number for Laverne Sullivan is 1023045200. It was assigned to this individual provider in the NPPES registry on June 26, 2006.

Q: What is Laverne Sullivan's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Q: When was this NPI record last updated?

The NPPES record for Laverne Sullivan was last updated on July 1, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 26, 2006

4210 FLAGSTAFF CV, FORT WAYNE, IN 46815(260) 489-9009(260) 489-5057 Get Directions Write a Review

NPPES record last updated: July 1, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Laverne A Sullivan Rd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAVERNE A SULLIVAN RD (NPI 1023045200) is an individual dietitian, registered in Fort Wayne, Indiana, licensed in Indiana (37000748A) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1023045200

Entity TypeIndividualFemale

Primary Taxonomy133V00000X

Provider Legal NameLAVERNE A SULLIVANCredential: RD

Location Address4210 FLAGSTAFF CVFort Wayne, IN 46815-4417

Mailing Address5244 Jeffries LaneNewburgh, IN 47630 · (812) 454-1710 · Fax (260) 489-5057

Phone(260) 489-9009

Fax(260) 489-5057

Sole ProprietorNo

Enumeration DateJune 26, 2006

Last NPPES UpdateJuly 1, 2014

✔ NPI 1023045200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers

Taxonomy Code133V00000X

License✔ Licensed in IN · 37000748A

Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

4210 FLAGSTAFF CV, Fort Wayne, IN 46815

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Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. KATHERINE R CAPEN RD LD

Dietitian, Registered