Provider Demographics
NPI:1588637607
Name:BUI OLIVER, BINH Q (APRN)
Entity Type:Individual
Prefix:MRS
First Name:BINH
Middle Name:Q
Last Name:BUI OLIVER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:BINH
Other - Middle Name:Q
Other - Last Name:BUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:4331 VINEYARD TRAIL
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039
Mailing Address - Country:US
Mailing Address - Phone:770-972-5121
Mailing Address - Fax:770-972-5121
Practice Address - Street 1:535 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1603
Practice Address - Country:US
Practice Address - Phone:404-761-4040
Practice Address - Fax:404-761-4008
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN127335363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN127335OtherGA BOARD OF NURSING
GA50BBIMFMedicare ID - Type Unspecified
GARN127335OtherGA BOARD OF NURSING