SAMANTHA JADE SULLIVAN

TUPELO, MS
NPI1497478812
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: MS  905575)
Enumeration Date2022-09-21
Last Update Date2022-09-21
Business Address
SAMANTHA JADE SULLIVAN APRN
830 S GLOSTER ST
TUPELO, MS 38801-4996
Phone number: 662-377-3270
Mailing Address
SAMANTHA JADE SULLIVAN APRN
830 S GLOSTER ST
TUPELO, MS 38801-4934
Phone number: 662-377-3270
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