Individual
MRS. AMANDA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1020 RIVER OAKS DR STE 310, FLOWOOD, MS 39232-9512
(601) 932-5006
(601) 932-5447
Mailing address
1020 RIVER OAKS DR 310, FLOWOOD, MS 39232-9512
(601) 932-5006
(601) 932-5447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R882573
MS
Other
Enumeration date
08/13/2015
Last updated
01/19/2016
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