Individual
STORMY TULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3504 MANSFIELD RD, SHREVEPORT, LA 71103-4107
(337) 991-9276
Mailing address
1509 DULLES DR, LAFAYETTE, LA 70506-3718
(337) 991-9276
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
221451
LA
Other
Enumeration date
09/30/2021
Last updated
09/30/2021
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