Individual
SALLIE DANIELE BUSSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
915 GORDON AVE, THOMASVILLE, GA 31792-6614
(229) 228-2716
Mailing address
915 GORDON AVE, THOMASVILLE, GA 31792-6699
(229) 228-2716
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN206902
GA
Other
Enumeration date
02/13/2020
Last updated
02/13/2020
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