Individual
MRS. VALERIE O'BRIANT SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
14724 HIGHWAY 15 N, LOUISVILLE, MS 39339-6318
(662) 773-7500
(662) 779-5006
Mailing address
8613 MS HIGHWAY 12, ACKERMAN, MS 39735-8917
(662) 285-9460
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R749408
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117849
—
MS
Enumeration date
05/13/2006
Last updated
03/10/2020
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