Individual
FELICIA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3341 YOUREE DR STE 205, SHREVEPORT, LA 71105-2149
(318) 219-4197
Mailing address
3341 YOUREE DR STE 205, SHREVEPORT, LA 71105-2149
(318) 219-4197
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20110506
LA
Other
Enumeration date
02/27/2018
Last updated
02/27/2018
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