Provider Demographics
NPI:1134195092
Name:BUSSOLETTI, APRIL J (NP)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:J
Last Name:BUSSOLETTI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 JESSE JEWELL PKWY SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3871
Mailing Address - Country:US
Mailing Address - Phone:770-297-7277
Mailing Address - Fax:770-533-7641
Practice Address - Street 1:1250 JESSE JEWELL PKWY SE
Practice Address - Street 2:SUITE 200
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3871
Practice Address - Country:US
Practice Address - Phone:770-297-7277
Practice Address - Fax:770-533-7641
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA115674363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA105673800AMedicaid
GAQ23530Medicare UPIN
GA50BBHRMMedicare ID - Type Unspecified