| Lorie Sullivan, | |
|
20 S Sixth St, Bay Springs, MS 39422-9055 | |
| (601) 764-4501 | |
| Not Available |
| Full Name | Lorie Sullivan |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 20 S Sixth St, Bay Springs, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518771161 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 907055 (Mississippi) | Primary |
| Entity Name | Independent Healthcare Management Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306909734 PECOS PAC ID: 0840197232 Enrollment ID: O20031215000487 |
| Mailing Address | Practice Location Address |
|---|---|
| Lorie Sullivan, 140 Thompson Rd, Lake, MS 39092-9495 Ph: (601) 527-2740 | Lorie Sullivan, 20 S Sixth St, Bay Springs, MS 39422-9055 Ph: (601) 764-4501 |
Mallory Odom Jordan, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 27 S Sixth St, Bay Springs, MS 39422 Phone: 601-764-2155 | |
Mrs. Pamela R Fail, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15 A South 6th Street, Bay Springs, MS 39422 Phone: 601-764-2101 Fax: 601-764-4789 | |
Mrs. Amber Miles, CFNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 20 S Sixth St, Bay Springs, MS 39422 Phone: 601-764-4494 Fax: 601-764-4649 | |
Margaret Fulkerson, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 20 S Sixth St, Bay Springs, MS 39422 Phone: 601-764-4501 Fax: 601-764-2301 | |
Mrs. Leanne Terrell Bynum, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 27 S Sixth St # A, Bay Springs, MS 39422 Phone: 601-764-2155 Fax: 601-764-2150 | |
Mrs. Kristen Leigh Ellzey, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 27 S Sixth St, Bay Springs, MS 39422 Phone: 601-764-2155 Fax: 601-764-2150 |