Provider Demographics
NPI:1831160340
Name:SULLIVAN, MEGHAN (NP)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:SULLIVAN
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EMBARCADERO CTR
Mailing Address - Street 2:LOBBY LEVEL
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-3823
Mailing Address - Country:US
Mailing Address - Phone:415-578-3100
Mailing Address - Fax:415-291-0489
Practice Address - Street 1:2 EMBARCADERO CTR
Practice Address - Street 2:LOBBY LEVEL
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-3823
Practice Address - Country:US
Practice Address - Phone:415-578-3100
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166237363LF0000X
CA18895363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q15209Medicare UPIN