Jaclynn Sullivan, is a
Licensed Practical Nurse based in Frazeysburg, Ohio. Jaclynn Sullivan is licensed to practice in Ohio (license number LPN.150884.MEDS-IV) and her current practice location is
5559 Raiders Road, Frazeysburg, Ohio. She can be reached at her office (for appointments etc.) via phone at
(740) 828-2498.
NPI number for Jaclynn Sullivan is 1013438126 and her current mailing address is 5559 Raiders Road, Frazeysburg, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1013438126.
Provider's Profile
Full Name | Jaclynn Sullivan |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 5559 Raiders Road, Frazeysburg, Ohio |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1013438126
- Provider Enumeration Date: 06/28/2017
- Last Update Date: 06/28/2017
Medical Identifiers
Medical identifiers for Jaclynn Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1013438126 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | LPN.150884.MEDS-IV (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jaclynn Sullivan is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jaclynn Sullivan, 5559 Raiders Road, Frazeysburg, OH 43822 Ph: () - | Jaclynn Sullivan, 5559 Raiders Road, Frazeysburg, OH 43822 Ph: (740) 828-2498 |
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