MARY SULLIVAN
NPI 1275627713
Nurse Practitioner in Portage, MI

Q: What is Mary Sullivan's NPI number?

The NPI number for Mary Sullivan is 1275627713. It was assigned to this individual provider in the NPPES registry on October 2, 2006.

Q: What is Mary Sullivan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Sullivan was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 October 02, 2006

8001 ANGLING ROAD, PORTAGE, MI 49024(269) 329-0944 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mary Sullivan NPPES

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

MARY SULLIVAN (NPI 1275627713) is an individual nurse practitioner in Portage, Michigan, licensed in Michigan (4704209403) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1275627713

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMARY SULLIVAN

Location Address8001 ANGLING ROADPortage, MI 49024

Mailing Address5943 Stadium Drive, Suite 3Kalamazoo, MI 49009

Phone(269) 329-0944

Sole ProprietorNo

Enumeration DateOctober 2, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1275627713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MI · 4704209403

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

8001 ANGLING ROAD, Portage, MI 49024

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Other Identifiers 1

Medicare UPINS99950

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Sullivan's NPI number?

The NPI number for Mary Sullivan is 1275627713. It was assigned to this individual provider in the NPPES registry on October 2, 2006.

Where is Mary Sullivan located?

Mary Sullivan practices at 8001 Angling Road, Portage, MI 49024. The listed phone number is (269) 329-0944.

What is Mary Sullivan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Mary Sullivan was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.