P Praxis·MD
● Active Type 1 · Individual

Cristianna F Sullivan, MD,

Dietitian, Registered·Salmon, ID· NPI 1336906528 · Enumerated 2024 · 2 years on NPI
Sullivan is 1 of 1 dietitian, registered providers in Salmon and 1 of 15 in Idaho.
NPI age
2 years
Enumerated 2024-03-04
Primary specialty
Dietitian, Registered
Licensed in
CA
1 state
Status
Active
No deactivations on record
Last NPPES update
2024-03-04
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 15 active dietitian, registered providers in Idaho.

NPI age
2 years
↓ 9 yr below median (11 yr)
State licenses
1 state
0% of peers hold multiple states
Subspecialties
0
40% of peers hold subspecialties

NPI lifetime · 2024 → 2026

2024-03Enumerated in NPPES
2024 2026

Where they practice

Practice location
25 Hokanson Ln Uppr Grande
Salmon, ID 834675114
📞 2084874839
Mailing address
25 Hokanson Ln Uppr Grande
Salmon, ID 834675114
📞 2084874839

Specialties

  • Dietitian, Registered Primary
    An individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill...
    CA license #C2813089 taxonomy 133VN1004X

Practice context

Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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