Individual provider · Type 1 NPI

Karli Sullivan, PA

Surgical Physician Assistant · Portland, ME

NPI number 1679259014 Active

Practice location

22 Bramhall St
Portland, ME 04102-3134

Call (207) 662-2934 Map

Fax (207) 662-6389

Other practice locations

  • 887 Congress St Ste 400, Portland, ME 04102-3163 · (207) 774-6368
  • 1 Capital Way Ste 390, Pennington, NJ 08534-2520 · (732) 426-3420

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA2826 (ME)
Surgical Physician Assistant 363AS0400X25MP00790300 (NJ)
Physician Assistant 363A00000XPA2826 (ME)

Surgical Physician Assistant: Definition to come...

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About NPI 1679259014

Karli Sullivan, PA's National Provider Identifier is 1679259014, issued on Jun 22, 2023. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Portland, ME. The record was last updated on May 13, 2026.