Gulsby, Tara Phelps
Gulsby, Tara Phelps is an individual health care provider with primary practice located at 3869 Highway 81 , Loganville GA 30052-3918. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Gulsby, Tara Phelps can be contacted via phone (678) 635-8650.Contact Information
Primary practice address
3869 Highway 81
Loganville GA 30052-3918
Phone: (678) 635-8650
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN209319 | Georgia |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | RN209319 | Georgia |
Profile Details
NPI number | 1568897767 |
---|---|
LBN Legal business name | Gulsby, Tara Phelps |
Credentials | NP-C |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 6th, 2013 |
Last updated | Aug 9th, 2022 - about 3 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1568897767 | NPPES |
Georgia | MEDICAID | 003143806G |
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