Provider Demographics
NPI:1639421217
Name:GULSBY, NEVA KAYE (PA-C)
Entity Type:Individual
Prefix:
First Name:NEVA
Middle Name:KAYE
Last Name:GULSBY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 LEE ROAD 115
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36804-9309
Mailing Address - Country:US
Mailing Address - Phone:770-313-7160
Mailing Address - Fax:
Practice Address - Street 1:2353 BENT CREEK RD
Practice Address - Street 2:SUITE 110
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-6431
Practice Address - Country:US
Practice Address - Phone:334-887-8707
Practice Address - Fax:334-887-8706
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006608363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant