Individual
MRS. BONITA C YESHURUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
688 BENTLEAF DR, DALLAS, GA 30132-1129
(678) 860-4430
Mailing address
80 PINE VALLEY RD STE 113, HIRAM, GA 30141-4976
(678) 996-5030
(678) 996-5021
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN288265
GA
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
11/09/2024
Last updated
12/02/2024
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