Individual
DOMINIQUE SHUNTA SULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5600 KEELE ST APT 1808, JACKSON, MS 39206-2047
(251) 550-7748
Mailing address
5600 KEELE ST APT 1808, JACKSON, MS 39206-2047
(251) 550-7748
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
60561
MS
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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