Provider Demographics
NPI:1982409785
Name:O'SULLIVAN, KATHLEEN HAMILTON (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:HAMILTON
Last Name:O'SULLIVAN
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:HAMILTON
Other - Last Name:O'SULLIVAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, FNP-BC
Mailing Address - Street 1:1112 HUNTMASTER TER NE UNIT 302
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-4560
Mailing Address - Country:US
Mailing Address - Phone:623-499-8530
Mailing Address - Fax:
Practice Address - Street 1:359 BROADWAY
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2350
Practice Address - Country:US
Practice Address - Phone:623-499-8530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024192539363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily