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Elizabeth Mary Sullivan

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

15 8th Ave N # 1, Hopkins, MN 55343-7611

PECOS Enrollment

This provider is enrolled in PECOS as ELIZABETH SULLIVAN.

Based on the most recent information from CMS, provider Elizabeth Mary Sullivan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1740717842
Provider Type
Individual
Full Name
Sullivan, Elizabeth Mary
Credential
NP

Gender
Female
Sole Proprietor
No
Enumeration Date
5/19/2017
Last Updated
5/6/2021

Contact Information

Practice Location

15 8th Ave N # 1, Hopkins, MN 55343-7611

(952) 933-5085

Unlisted Fax

Mailing Location

15 8th Ave N # 1, Hopkins, MN 55343-7611

(952) 933-5085

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 5319 Minnesota

Elizabeth Mary Sullivan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Leonce-Badio, Francisca S

Cobb, Joel C

Capron, Scott A

Boulet, Jimi Leah

Nicholas, Jean L

Depas, Shelby A

Deal, Megan Mosley

Graf, Angelita L

Bowen, Alice

Workheiser, Kathryn M