Individual
JACQUELINE ROSEANN BUSHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3480 PRESTON RIDGE RD STE 500, ALPHARETTA, GA 30005-5460
(470) 916-7201
(470) 220-4066
Mailing address
3480 PRESTON RIDGE RD STE 500, ALPHARETTA, GA 30005-5460
(470) 916-7201
(470) 220-4066
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
RN177666
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN177666
GA
Other
Enumeration date
10/27/2020
Last updated
03/10/2026
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