Organization
SOUTHERN CROSS AT HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY BUNKER APRN, FNP-BC, NP-C (OWNER - FOUNDER)
(770) 317-8244
Entity
Organization
Contact information
Practice address
980 BIRMINGHAM RD, STE 501-330, MILTON, GA 30004-4417
(770) 317-8244
Mailing address
980 BIRMINGHAM RD, STE 501-330, MILTON, GA 30004-4417
(770) 317-8244
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
FNP/RN173575
GA
Other
Enumeration date
11/28/2016
Last updated
11/28/2016
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