Individual
LAUREN B SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
230 AIRLINE RD, COLUMBUS, MS 39702-6348
(662) 570-3208
Mailing address
149 DOVE WHITAKER RD, CALEDONIA, MS 39740-9757
(662) 570-3208
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906275
MS
Other
Enumeration date
09/25/2023
Last updated
02/08/2024
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