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

Kathleen Lea Sullivan, APRN

Individual provider Pediatric Nurse Practitioner · NPI 1811204985

Kathleen Lea Sullivan, APRN is a Nurse Practitioner in Waterbury, Connecticut. Qualified in 2010, 16 years ago. Works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Connecticut.

Years since qualifying
16
Licensed in
CT
In the registry since
2010
Specialties on file
2
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

134 Grandview Ave 208
Waterbury, CT 06708-2507
Phone: (203) 755-3279
Fax: (203) 755-3057
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 123 S Main St Ste 110b, Newtown, CT 06470-5313 — (203) 770-5963

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4478 (CT)
Pediatric Nurse Practitioner Taxonomy 363LP0200X · Licence 004478 (CT)

Record details

NPI number1811204985
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN
Sole proprietorNo
NPI enumeratedSeptember 9, 2010
Last updated in NPPESJuly 24, 2026
Certification dateJuly 24, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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