Individual
MRS. MIYOSHI UMEAKIIRETTA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8918 BEAU CHASSE DR, SHREVEPORT, LA 71115-2774
(318) 458-8025
Mailing address
8918 BEAU CHASSE DR, SHREVEPORT, LA 71115-2774
(318) 458-8025
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
107759
LA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
107759
LA
Other
Enumeration date
11/18/2025
Last updated
11/18/2025
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