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

Individual provider Registered Dietitian · NPI 1023045200

Laverne A Sullivan, RD is a Registered Dietitian in Fort Wayne, Indiana. Licensed in Indiana. Registered with an NPI since 2006.

Licensed in
IN
In the registry since
2006
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.

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Practice location Address checks out

4210 Flagstaff Cv
Fort Wayne, IN 46815-4417
Phone: (260) 489-9009
Fax: (260) 489-5057
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 37000748A (IN)

Record details

NPI number1023045200
Entity typeIndividual (Type 1)
GenderFemale
Credentials RD
Sole proprietorNo
NPI enumeratedJune 26, 2006
Last updated in NPPESJuly 1, 2014
Mailing address5244 Jeffries Lane, Newburgh, IN 47630

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