Individual
JACQUELYN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1270 OCEAN SPRINGS RD, OCEAN SPRINGS, MS 39564-3409
(228) 875-3033
(228) 875-3989
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 497-7576
(228) 497-8869
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904843
MS
Other
Enumeration date
09/28/2021
Last updated
11/12/2021
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