NPI age
2 years
Enumerated 2024-03-04
● Active
Type 1 · Individual
Cristianna F Sullivan, MD,
Sullivan is 1 of 1 dietitian, registered providers in Salmon and 1 of 15 in Idaho.
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
Mailing address
25 Hokanson Ln Uppr Grande
Salmon, ID 834675114
Specialties
-
Dietitian, Registered PrimaryAn 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...
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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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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