Individual
KATHLEEN E SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
96 DORMITORY ROW WEST, UNIVERSITY, MS 38677
(615) 948-3271
Mailing address
281 HIGHWAY 7 S, OXFORD, MS 38655-8139
(615) 948-3271
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10704472
ATHLETIC TRAINING STUDENT
MS
Enumeration date
06/07/2022
Last updated
02/27/2024
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