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1740360353
WANDA J SULLIVAN
RUSTON, LA
NPI
1740360353
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: LA RN073140)
Enumeration Date
2006-10-17
Last Update Date
2016-02-18
Business Address
-- WANDA J SULLIVAN RN
765 S BONNER ST
RUSTON, LA 71270-5801
Phone number: 318-202-5935
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Mailing Address
-- WANDA J SULLIVAN RN
PO BOX 1839
RUSTON, LA 71273-1839
Phone number: 318-202-5935
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