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General NPI Number Information
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NPI Number | 1902747967
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Entity Type | Individual
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Provider Name | VANITA S PULLIAM MSN, ACNP
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Gender | Female
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 614 S 8TH ST
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City | GRIFFIN
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State | GA
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Zip | 30224-4214
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Country | US
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Telephone | 678-688-8140
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Fax | 470-204-8997
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Provider Business Mailing Address
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Address Line | 430 ROCK VIEW LN
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City | COVINGTON
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State | GA
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Zip | 30016-8222
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Country | US
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Telephone | 678-688-8140
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Fax | 470-204-8997
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN-NP276487
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License Number State | GA
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