BERTHA SIEDAH SULLIVN

JACKSON, MS
NPI1831729417
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy163W00000X Registered Nurse
(Licence: MS  895742)
Additional Taxonomies163W00000X Registered Nurse
(Licence: AL  141-222)
163WM0705X Registered Nurse, Medical-Surgical
(Licence: MS  895742)
Enumeration Date2020-01-22
Last Update Date2020-01-22
Business Address
BERTHA SIEDAH SULLIVN rn
635 HAMPTON WAY APT C
JACKSON, MS 39211-2300
Phone number: 662-466-2208
Mailing Address
BERTHA SIEDAH SULLIVN rn
635 HAMPTON WAY
JACKSON, MS 39211-2300
Phone number: 662-466-2208