| Shamecka Sullivan, PMHNP | |
| 
					1000 Neighborhood Pl, Fairdale, KY 40118-9697  | |
| (502) 361-2381 | |
| (502) 996-8309 | 
| Full Name | Shamecka Sullivan | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Psychiatric/mental Health | 
| Location | 1000 Neighborhood Pl, Fairdale, Kentucky | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1023840717 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 4024554 (Kentucky) | Primary | 
| Entity Name | Family Health Centers, Inc. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1649732603 PECOS PAC ID: 6901700053 Enrollment ID: O20031121000045  | 
| Entity Name | Extended Care Specialists, Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1134146079 PECOS PAC ID: 2466407713 Enrollment ID: O20190703001141  | 
| Entity Name | Eventus Wholehealth Midwest Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1386252757 PECOS PAC ID: 4183040470 Enrollment ID: O20211217001894  | 
| Entity Name | Eventus Ecs, Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1073353496 PECOS PAC ID: 2163969650 Enrollment ID: O20240910001036  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Shamecka Sullivan, PMHNP Po Box 392552, Pittsburgh, PA 15251-9500 Ph: (512) 792-4402  | Shamecka Sullivan, PMHNP 1000 Neighborhood Pl, Fairdale, KY 40118-9697 Ph: (502) 361-2381  | 
Mrs. Ieshia Miya Blakey, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1000 Neighborhood Pl, Fairdale, KY 40118 Phone: 502-361-2381 Fax: 502-996-8309  | |
Terrica Michelle Flowers, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1000 Neighborhood Pl, Fairdale, KY 40118 Phone: 502-361-2381 Fax: 502-996-8309  | |
Dona J Meers, C.N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1000 Neighborhood Pl, Fairdale, KY 40118 Phone: 502-361-2381 Fax: 502-363-1463  |