| Ms Pamela Sue Sullivan, GNP | |
|
40055 Bob Hope Dr Ste B, Rancho Mirage, CA 92270-3940 | |
| (760) 202-3946 | |
| (760) 770-4392 |
| Full Name | Ms Pamela Sue Sullivan |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Gerontology |
| Location | 40055 Bob Hope Dr Ste B, Rancho Mirage, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336267699 | NPI | - | NPPES |
| 1409819 | Other | CA | CIGNA |
| 4984336 | Other | CA | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WG0600X | Registered Nurse - Gerontology | 262478 (California) | Secondary |
| 363LG0600X | Nurse Practitioner - Gerontology | 12764 (California) | Primary |
| Entity Name | Paragon Chico Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528527181 PECOS PAC ID: 2668807785 Enrollment ID: O20200120000695 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Pamela Sue Sullivan, GNP 2160 Colonial Blvd, Fort Myers, FL 33907-1410 Ph: (239) 931-7342 | Ms Pamela Sue Sullivan, GNP 40055 Bob Hope Dr Ste B, Rancho Mirage, CA 92270-3940 Ph: (760) 202-3946 |
Ervin Xhufka, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 39000 Bob Hope Dr, Rancho Mirage, CA 92270 Phone: 760-837-8542 Fax: 760-837-8543 | |
Ms. Rosie Knauf, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 39000 Bob Hope Dr, Rancho Mirage, CA 92270 Phone: 760-340-3911 | |
Cynthia Jovanov, RN, ACNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 39000 Bob Hope Dr, Rancho Mirage, CA 92270 Phone: 760-340-3911 Fax: 760-773-1885 | |
Richard Pessagno, DNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 39000 Bob Hope Dr, Rancho Mirage, CA 92270 Phone: 760-837-8767 Fax: 760-837-8806 | |
Maria Florina Aleth D Mangosing Ignacio, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 39000 Bob Hope Dr, Rancho Mirage, Rancho Mirage, CA 92270 Phone: 760-837-8535 | |
Dr. Leesa Simanton Booth, DNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 119 Calle De Las Rosas, Rancho Mirage, CA 92270 Phone: 760-578-3601 | |
April Marie Lopez, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 39000 Bob Hope Dr, Rancho Mirage, CA 92270 Phone: 760-346-7655 Fax: 760-346-3037 |