Individual
SUE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1409 BRADEN ST, JACKSONVILLE, AR 72076-3720
(501) 982-0576
(501) 982-0041
Mailing address
1409 BRADEN ST, JACKSONVILLE, AR 72076-3720
(501) 982-0576
(501) 982-0041
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A01183
AR
Other
Enumeration date
04/07/2008
Last updated
11/17/2011
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