Healthcare Provider Details

I. General information

NPI: 1134195092
Provider Name (Legal Business Name): APRIL J. BUSSOLETTI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 03/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 JESSE JEWELL PKWY SE SUITE 200
GAINESVILLE GA
30501-3871
US

IV. Provider business mailing address

1250 JESSE JEWELL PKWY SE SUITE 200
GAINESVILLE GA
30501-3871
US

V. Phone/Fax

Practice location:
  • Phone: 770-297-7277
  • Fax: 770-533-7641
Mailing address:
  • Phone: 770-297-7277
  • Fax: 770-533-7641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number115674
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: