Active NPIIndividual provider

Alyssa R Sullivan

Nurse Practitioner, Family in Avon, Connecticut

NPI Number1417662156
Practice location
385 W Main St, Avon, CT 06001-4357
Fax
—
Last updated
April 23, 2026

Alyssa Renee Sullivan is a Nurse Practitioner, Family based in Avon, CT. Alyssa Renee Sullivan practices in Avon, CT. The NPI Number for Alyssa Renee Sullivan is 1417662156 and holds a License No. 12.011734 (CT). The current practice location address for Alyssa Renee Sullivan is 385 W Main St, Avon, CT 06001-4357 and can be reached out via phone at 860-777-1280.

Provider Profile Details

NPI Number
1417662156
Provider Name
Alyssa Renee Sullivan
Provider Entity Type
Individual
Gender
Female
Address
385 W Main St, Avon, CT 06001-4357
Phone Number
860-777-1280
Primary Taxonomy
Nurse Practitioner, Family · 363LF0000X
Sole Proprietor
No
Provider Enumeration Date
January 17, 2023
Last Update Date
April 23, 2026
Certification Date
April 23, 2026
NPI Status
Active

Provider Business Practice Location Address Details

Address
385 W Main St
Avon, CT 06001-4357
City
Avon
Zip
06001-4357
Phone Number
860-777-1280
Avon, CT 06001Get directions →

Provider Business Mailing Address Details

Address
1290 Silas Deane Hwy
Hartford Healthcare-Cvo
Wethersfield, CT 06109-4337
City
Wethersfield
State
CT
Zip
06109-4337

License Information

License Number
12.011734
License State
CT
Taxonomy
Nurse Practitioner, Family · 363LF0000X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Alyssa R Sullivan?

The NPI number of Alyssa R Sullivan is 1417662156. It was assigned on January 17, 2023 and is currently active in the NPPES registry.

What is the specialty of Alyssa R Sullivan?

Alyssa R Sullivan is registered under the primary taxonomy Nurse Practitioner, Family (code 363LF0000X), licensed in CT under license number 12.011734.

Where does Alyssa R Sullivan practice?

The practice location is 385 W Main St, Avon, CT 06001-4357. The office can be reached at 860-777-1280 (phone).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1417662156 directly on the NPPES registry website.

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