Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jaclyn Sullivan, LAT

Individual provider Athletic Trainer · NPI 1992423867

Jaclyn Sullivan, LAT is an Athletic Trainer in Green Bay, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2022.

Licensed in
WI
In the registry since
2022
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

See every abbreviation used in this directory →

Practice location Address checks out

744 S Webster Ave
Green Bay, WI 54301-3505
Phone: (920) 433-3500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 244739 (WI)

Record details

NPI number1992423867
Entity typeIndividual (Type 1)
GenderFemale
Credentials LAT
Sole proprietorNo
NPI enumeratedAugust 17, 2022
Last updated in NPPESAugust 17, 2022
Certification dateAugust 17, 2022

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