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Organization

CHANTAL SULLIVAN APRN-BC PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CHANTAL SULLIVAN APRN (NURSE PRACTITIONER)
(228) 331-3310
Entity
Organization

Contact information

Practice address
8990 LORRAINE RD, GULFPORT, MS 39503-4176
(228) 331-3310
Mailing address
928 COURTHOUSE RD UNIT 6, GULFPORT, MS 39507-4110
(720) 271-0941

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
03/09/2020
Last updated
03/11/2020
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