Sullivn, Bertha Siedah

Sullivn, Bertha Siedah is an individual health care provider with primary practice located at 635 Hampton Way Apt C , Jackson MS 39211-2300. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Medical-Surgical. Nursing Service Providers / Registered Nurse is her primary health care specialty. Sullivn, Bertha Siedah can be contacted via phone (662) 466-2208.

Contact Information

Primary practice address
635 Hampton Way Apt C Jackson MS 39211-2300
Phone: (662) 466-2208
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 141-222 Alabama
Nursing Service Providers / Medical-Surgical 163WM0705X 895742 Mississippi
Nursing Service Providers / Registered Nurse 163W00000X 895742 Mississippi

Profile Details

NPI number 1831729417
LBN Legal business name Sullivn, Bertha Siedah
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2020
Last updated Jan 22nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831729417 NPPES
Mississippi Other 895742 MS BOARD OF NURSING

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