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

Individual provider Certified Registered Nurse Anesthetist · NPI 1609223205

Sally Sullivan, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Jackson, Mississippi. Qualified in 2016, 10 years ago. Practices with Gac Anesthesia LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
10
Licensed in
MS
In the registry since
2016
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

971 Lakeland Dr
Jackson, MS 39216-4643
Phone: (334) 279-1450
Fax: (334) 395-4110
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence R892793 (MS)

Record details

NPI number1609223205
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNA
Sole proprietorNo
NPI enumeratedMay 24, 2016
Last updated in NPPESMay 24, 2016
Mailing addressPo Box 4608, Jackson, MS 39296-4608

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Gac Anesthesia Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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