Individual
JYSSICA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
261 HIGHWAY 132, MANGHAM, LA 71259-5269
(318) 248-2807
(318) 248-2967
Mailing address
130 DESIARD ST STE 355, MONROE, LA 71201-7363
(318) 807-7875
(318) 812-6603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP09853
LA
Other
Enumeration date
03/06/2018
Last updated
08/07/2019
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