| 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 |