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

Jessie Lynn Sullivan, NP

Individual provider Registered Nurse · NPI 1790310589

Jessie Lynn Sullivan, NP is a Nurse Practitioner in Grand Rapids, Michigan. Qualified in 2025, 1 year ago. Practices with Advantage Health/Saint Mary's Medical Group, a 494-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
1
Licensed in
MI
In the registry since
2020
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

3075 Orchard Vista Dr SE
Grand Rapids, MI 49546-7069
Phone: (616) 301-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 220 Cherry St Se # 1, Grand Rapids, MI 49503-4608 — (616) 685-5050

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704301679 (MI)
Registered Nurse Taxonomy 163W00000X · Licence 4704301679 (MI)

Record details

NPI number1790310589
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedMarch 11, 2020
Last updated in NPPESOctober 27, 2025
Certification dateOctober 27, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Advantage Health/Saint Mary'S Medical Group — 494 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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