Individual
CASSANDRA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
502 WOODLAND HILLS DR, OXFORD, MS 38655-9790
(662) 236-1478
Mailing address
502 WOODLAND HILLS DR, OXFORD, MS 38655-9790
(662) 236-1478
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
10656
KY
183500000X
Pharmacist
Primary
T-09630
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T-09630
MS LICENSE NUMBER
MS
Enumeration date
08/19/2019
Last updated
08/19/2019
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