Individual
DR. SUSAN MICHELE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1600 W MAIN ST, WALNUT RIDGE, AR 72476-9401
(870) 886-2806
Mailing address
510 HERBIE RD, RAVENDEN SPRINGS, AR 72460-9340
(870) 219-2078
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD08754
AR
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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