Individual
ASHLI NICOLE BUSSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 GASKIN AVE N, DOUGLAS, GA 31533-3021
(912) 592-2817
Mailing address
618 ROPER ST, DOUGLAS, GA 31533-4031
(912) 592-2817
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
GA
253Z00000X
In Home Supportive Care Agency
Primary
—
GA
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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