Individual
KARON BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
12013 RANDALL WOODS DR, MIDLAND, GA 31820-4544
(706) 566-7726
Mailing address
12013 RANDALL WOODS DR, MIDLAND, GA 31820-4544
(706) 566-7726
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R060034
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00837801A
—
GA
Enumeration date
09/06/2018
Last updated
09/06/2018
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