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

Jamie Sullivan, CRNP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1407353717

Jamie Sullivan, CRNP is a Nurse Practitioner in Honesdale, Pennsylvania. Qualified in 2018, 8 years ago. Practices with Moonshot Psychiatric Nurse Practitioner PC, a 76-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Pennsylvania.

Years since qualifying
8
Licensed in
PA
In the registry since
2018
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

600 Maple Ave Ste 15
Honesdale, PA 18431-1460
Phone: (570) 253-8219
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence SP018680 (PA)

Record details

NPI number1407353717
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedApril 12, 2018
Last updated in NPPESApril 12, 2018
Mailing address601 Park St, Honesdale, PA 18431-1445

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Moonshot Psychiatric Nurse Practitioner Pc — 76 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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