Individual
LORIE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9427 EASTSIDE DRIVE EXT # A, NEWTON, MS 39345-8063
(601) 683-0330
(601) 635-3746
Mailing address
140 THOMPSON RD, LAKE, MS 39092-9495
(601) 527-2740
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
907055
MS
Other
Enumeration date
02/04/2025
Last updated
12/28/2025
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