Individual provider · Type 1 NPI
Jerry Sullivan, CFNP
Family Nurse Practitioner · Woodland, MS
NPI number
1457409807
Active
Practice location
120 Market Street
Woodland, MS 39776
Fax (662) 456-7335
Mailing address
P. O. Box 186, 120 Market Street
Woodland, MS 39776
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | R739537 (MS) |
Family Nurse Practitioner: Definition to come...
About NPI 1457409807
Jerry Sullivan, CFNP's National Provider Identifier is 1457409807, issued on Jan 8, 2007. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Woodland, MS. The record was last updated on Feb 17, 2011.