Individual
MS. CARLA BOURELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2591 CANDLER RD, DECATUR, GA 30032-6502
(770) 310-8686
Mailing address
2591 CANDLER RD, DECATUR, GA 30032-6502
(770) 310-8686
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
287303
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
287303
GA
Other
Enumeration date
07/08/2011
Last updated
07/06/2022
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