Individual
GAELLE MAVILUKA BULABULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13090 PETIGRU DR, CARMEL, IN 46032-4436
(317) 733-8608
Mailing address
2620 ELM HILL PIKE, NASHVILLE, TN 37214-3108
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71013415A
IN
Other
Enumeration date
11/01/2022
Last updated
10/17/2024
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