Mrs Amanda Marie Sullivan, LPN, is a
Licensed Practical Nurse based in Fall River, Wisconsin. Mrs Amanda Marie Sullivan is licensed to practice in Wisconsin (license number 304840-31) and her current practice location is
610 N Main St, Fall River, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(920) 382-5666.
NPI number for Mrs Amanda Marie Sullivan is 1407121221 and her current mailing address is 610 N Main St, Fall River, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1407121221.
Provider's Profile
Full Name | Mrs Amanda Marie Sullivan |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 610 N Main St, Fall River, Wisconsin |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1407121221
- Provider Enumeration Date: 03/12/2012
- Last Update Date: 03/13/2012
Medical Identifiers
Medical identifiers for Mrs Amanda Marie Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407121221 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 304840-31 (Wisconsin) | 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. Mrs Amanda Marie 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 |
Mrs Amanda Marie Sullivan, LPN, 610 N Main St, Fall River, WI 53932-9570 Ph: (920) 382-5666 | Mrs Amanda Marie Sullivan, LPN, 610 N Main St, Fall River, WI 53932-9570 Ph: (920) 382-5666 |
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