Individual
MRS. KALIE MULLIS BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1520 LUCKY ST, GRIFFIN, GA 30223-1176
(770) 710-3225
Mailing address
1520 LUCKY ST, GRIFFIN, GA 30223-1176
(678) 488-2602
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN258283
GA
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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