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

Kelli Anne-Marie Sullivan

Individual provider Family Nurse Practitioner · NPI 1386408656

Kelli Anne-Marie Sullivan is a Nurse Practitioner in Shawnee, Oklahoma. Qualified in 2023, 3 years ago. Practices with Oklahoma Pain Management PLLC, an 8-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
3
Licensed in
OK
In the registry since
2024
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Practice location Address checks out

4409 N Kickapoo Ave
Shawnee, OK 74804-1206
Phone: (405) 242-4100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 216574 (OK)

Record details

NPI number1386408656
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 7, 2024
Last updated in NPPESFebruary 7, 2024
Certification dateJanuary 30, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Oklahoma Pain Management Pllc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Shawnee