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

MS. Miya Venetia Sullivan, MS, ATC

Individual provider Athletic Trainer · NPI 1649488503

MS. Miya Venetia Sullivan, MS, ATC is an Athletic Trainer in Saint Louis, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2007
What do these letters mean?
MS — Master of Science
A graduate science degree.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

3672 W Pine Mall Blvd Athletics
Saint Louis, MO 63108-3304
Phone: (314) 977-7024
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2000170998 (MO)

Record details

NPI number1649488503
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , ATC
Sole proprietorYes
NPI enumeratedMay 21, 2007
Last updated in NPPESJuly 8, 2007

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