Provider Demographics
NPI:1790067486
Name:SUTTON, ABBY (FNP C)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:SUTTON
Suffix:
Gender:F
Credentials:FNP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 TYLER DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-5745
Mailing Address - Country:US
Mailing Address - Phone:662-680-9368
Mailing Address - Fax:662-842-4709
Practice Address - Street 1:70 MEDICAL PLZ
Practice Address - Street 2:
Practice Address - City:EUPORA
Practice Address - State:MS
Practice Address - Zip Code:39744-4018
Practice Address - Country:US
Practice Address - Phone:662-258-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR619264363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner