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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 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 1568897767 NPPES
Georgia MEDICAID 003143806G

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