MARYELLEN SULLIVAN NP
NPI 1306812086
Nurse Practitioner - Adult Health in Waltham, MA
About Maryellen Sullivan Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARYELLEN SULLIVAN NP (NPI 1306812086) is an individual adult health provider in Waltham, Massachusetts, licensed in Massachusetts (142612) and active in the NPI registry since February 2006.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Maryellen Sullivan's NPI number?
The NPI number for Maryellen Sullivan is 1306812086. It was assigned to this individual provider in the NPPES registry on February 23, 2006.
Where is Maryellen Sullivan located?
Maryellen Sullivan practices at 950 Winter Street, Waltham, MA 02451. The listed phone number is (781) 472-8787.
What is Maryellen Sullivan's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
When was this NPI record last updated?
The NPPES record for Maryellen Sullivan was last updated on September 17, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Maryellen Sullivan, NP · NPI 1306812086
Adult Health physician in Waltham, Massachusetts. Individual provider, active in the CMS NPPES registry since February 23, 2006.
## Identity
- **NPI:** 1306812086 (Entity type: Individual)
- **Enumerated:** February 23, 2006
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **State license:** 142612 (Massachusetts)
- **Sole proprietor:** No
## Practice location
- **Address:** 950 WINTER STREET, Waltham, MA 02451
- **Phone:** (781) 472-8787
## Record status
- **NPPES last updated:** September 17, 2015
- **Other identifiers:** Medicare ID-Type Unspecified NP2814 (MA); Medicare UPIN P16935 (MA)
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Source: [NPI Profile](https://npiprofile.com/npi/1306812086) · Data from the CMS NPPES public registry.