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General NPI Number Information
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NPI Number | 1225954175
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Entity Type | Individual
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Provider Name | ACQUILLA LABUKU GBUNBLEE RN
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Gender | Female
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Dates
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Enumeration Date | 06/25/2026
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Last Update Date | 06/25/2026
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Provider Practice Location Address
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Address Line | 333 SWANSON DR STE 126
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-8539
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Country | US
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Telephone | 678-777-3857
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Fax | 678-990-9094
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Provider Business Mailing Address
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Address Line | 333 SWANSON DR STE 126
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-8539
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Country | US
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Telephone | 678-777-3857
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Fax | 678-990-9094
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 173910
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License Number State | NC
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