Individual
SHARLENE CAMPBELL SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2408 BROADMOOR BLVD STE B, MONROE, LA 71201-2994
(318) 807-0525
(318) 807-1077
Mailing address
130 DESIARD ST STE 355, MONROE, LA 71201-7363
(318) 807-7875
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP09503
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2451847
—
LA
Enumeration date
06/21/2017
Last updated
06/13/2019
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