Bush, Vickie Consuella71

Bush, Vickie Consuella71 is an sole proprietor health care provider with primary practice located at 3701 Bermuda Run Dr , Valdosta GA 31605-1059. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Agencies / In Home Supportive Care. Agencies / In Home Supportive Care is her primary health care specialty. Bush, Vickie Consuella71 can be contacted via phone (229) 292-0021.

Contact Information

Primary practice address
3701 Bermuda Run Dr Valdosta GA 31605-1059
Phone: (229) 292-0021
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 456669 Georgia
Agencies / In Home Supportive Care 253Z00000X

Profile Details

NPI number 1912464702
LBN Legal business name Bush, Vickie Consuella71
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 27th, 2019
Last updated Feb 28th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912464702 NPPES
Georgia Other 456669 ARRT

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