Individual
MR. IDRIS BUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
20 HERRELL RD, VILLA RICA, GA 30180-5527
(770) 812-3266
Mailing address
20 HERRELL RD, VILLA RICA, GA 30180-5527
(770) 812-3530
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN-NP216420
GA
Other
Enumeration date
04/17/2023
Last updated
10/10/2025
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