MOLLY SULLIVAN NPI 1265983316

NPI Information

  • NPI: 1265983316
  • Provider Name: MOLLY SULLIVAN
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 350 W WOODROW WILSON AVE
    JACKSON, MS
    ZIP 39213
  • Phone: (601) 815-0157

Map and Directions

Get Directions

NPI Details

Molly Sullivan is a family nurse practitioner in Jackson, MS. Molly Sullivan NPI is 1265983316. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

350 W WOODROW WILSON AVE
JACKSON, MS
ZIP 39213-681
Phone: (601) 815-0157
Fax: (601) 984-5257

The NPI 1265983316 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of skin and tissue, each additional 20.0 sq cm or less (HCPCS:11045)
  • Removal of skin and tissue, 20.0 sq cm or less (HCPCS:11042)
  • Established patient home visit, typically 40 minutes (HCPCS:99349)
  • Established patient home visit, typically 25 minutes (HCPCS:99348)

The enumeration date for this NPI number is 10/24/2016 and was last updated on 12/28/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily901715MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1546099YJ5DMEDICARE PINMISSISSIPPI
204950045MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI