Individual
JESSICA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP, DNP
Contact information
Practice address
4330 HIGHWAY 78 E STE 114, JASPER, AL 35501-8955
(205) 512-1122
Mailing address
424 MATTHEWS DR, JASPER, AL 35503-6052
(205) 544-5663
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-162940
AL
363LP0200X
Pediatric Nurse Practitioner
Primary
1-162940
AL
Other
Enumeration date
11/09/2019
Last updated
03/10/2026
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