Individual provider · Type 1 NPI
Kathleen M. Sullivan, APRN
Psychiatric/Mental Health Nurse Practitioner · Lago Vista, TX
NPI number
1306095955
Active
Practice location
20511 Sunset Ln
Lago Vista, TX 78645-6245
Fax (860) 760-6113
Other practice locations
- 95 Sockanosset Cross Rd Ste 305, Cranston, RI 02920-5559 · (401) 946-6400
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 3862 (CT) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | NPP37789 (RI) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
About NPI 1306095955
Kathleen M. Sullivan, APRN's National Provider Identifier is 1306095955, issued on Sep 18, 2008. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Lago Vista, TX. The record was last updated on May 19, 2026.