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

Michael John Sullivan, AGACNP

Individual provider Acute Care Nurse Practitioner · NPI 1760299267

Michael John Sullivan, AGACNP is a Nurse Practitioner in Bridgeport, Connecticut. Qualified in 2024, 2 years ago. Practices with Impact Health PC, a 79-clinician group. Licensed in Connecticut.

Years since qualifying
2
Licensed in
CT
In the registry since
2024

Practice location Address checks out

267 Grant St
Bridgeport, CT 06610-2870
Phone: (203) 384-3000
Show map & directions

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

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 14369 (CT)

Record details

NPI number1760299267
Entity typeIndividual (Type 1)
GenderMale
Credentials AGACNP
Sole proprietorYes
NPI enumeratedDecember 17, 2024
Last updated in NPPESJanuary 16, 2025
Certification dateJanuary 16, 2025
Mailing address267 Grant St, Bridgeport, CT 06610-2870

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Impact Health Pc — 79 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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