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BERTHA SIEDAH SULLIVN RN
NPI 1831729417
Registered Nurse in Jackson, MS

Active since January 22, 2020
635 HAMPTON WAY APT C, JACKSON, MS 39211(662) 466-2208 Get Directions Write a Review

NPPES record last updated: January 22, 2020. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Bertha Siedah Sullivn Rn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BERTHA SIEDAH SULLIVN RN (NPI 1831729417) is an individual registered nurse in Jackson, Mississippi, licensed in Mississippi (895742) and active in the NPI registry since January 2020.

NPPES Registry Identity

NPI1831729417
Entity TypeIndividualFemale
Primary Taxonomy163W00000X
Provider Legal NameBERTHA SIEDAH SULLIVNCredential: RN
Location Address635 HAMPTON WAY APT CJackson, MS 39211-2300
Mailing Address635 Hampton WayJackson, MS 39211-2300 · (662) 466-2208
Phone(662) 466-2208
Sole ProprietorNo
Enumeration DateJanuary 22, 2020
✔ NPI 1831729417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRegistered NurseNursing Service Providers
Taxonomy Code163W00000X
Licenses✔ Licensed in MS · 895742✔ Licensed in AL · 141-222
Definition
(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.
Also ListedRegistered Nurse · Medical-SurgicalTaxonomy 163WM0705X · License 895742 (MS)
635 HAMPTON WAY APT C, Jackson, MS 39211
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Other Identifiers 1

Other895742MS · Ms Board Of Nursing

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bertha Sullivn's NPI number?

The NPI number for Bertha Sullivn is 1831729417. It was assigned to this individual provider in the NPPES registry on January 22, 2020.

Where is Bertha Sullivn located?

Bertha Sullivn practices at 635 Hampton Way Apt C, Jackson, MS 39211. The listed phone number is (662) 466-2208.

What is Bertha Sullivn's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

When was this NPI record last updated?

The NPPES record for Bertha Sullivn was last updated on January 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.