Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Molly Sullivan

Individual provider Family Nurse Practitioner · NPI 1265983316

Molly Sullivan is a Nurse Practitioner in Jackson, Mississippi. Qualified in 2016, 10 years ago. Practices with Convenient Care Clinic LLC, a 19-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
10
Licensed in
MS
In the registry since
2016
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Practice location Address checks out

350 W Woodrow Wilson Ave
Jackson, MS 39213-7681
Phone: (601) 815-0157
Fax: (601) 984-5257
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 901715 (MS)

Record details

NPI number1265983316
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 24, 2016
Last updated in NPPESDecember 28, 2016
Mailing address2500 N State St, Jackson, MS 39216-4500

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Convenient Care Clinic Llc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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