Mrs Tara Roberta Sullivan, RN,IBCLC,LCCE - Registered Nurse in Dearborn, MI

Mrs Tara Roberta Sullivan, RN,IBCLC,LCCE is a Registered Nurse - Lactation Consultant based in Dearborn, Michigan. Mrs Tara Roberta Sullivan is licensed to practice in Michigan (license number 4704245099) and her current practice location is 24808 Boston St, Dearborn, Michigan. She can be reached at her office (for appointments etc.) via phone at (313) 618-4206.

NPI number for Mrs Tara Roberta Sullivan is 1841814456 and her current mailing address is 24808 Boston St, Dearborn, Michigan. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1841814456.

Contact Information

Mrs Tara Roberta Sullivan, RN,IBCLC,LCCE
24808 Boston St,
Dearborn, MI 48124-4411
(313) 618-4206
Not Available

Map and Direction




Provider's Profile

Full NameMrs Tara Roberta Sullivan
GenderFemale
SpecialityRegistered Nurse - Lactation Consultant
Location24808 Boston St, Dearborn, Michigan
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1841814456
  • Provider Enumeration Date: 05/31/2020
  • Last Update Date: 05/31/2020

Medical Identifiers

Medical identifiers for Mrs Tara Roberta Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1841814456NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WL0100XRegistered Nurse - Lactation Consultant 4704245099 (Michigan)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 Tara Roberta 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 AddressPractice Location Address
Mrs Tara Roberta Sullivan, RN,IBCLC,LCCE
24808 Boston St,
Dearborn, MI 48124-4411

Ph: (313) 618-4206
Mrs Tara Roberta Sullivan, RN,IBCLC,LCCE
24808 Boston St,
Dearborn, MI 48124-4411

Ph: (313) 618-4206

Reviews and Comments


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