Provider Demographics
NPI:1184978785
Name:PULLIAM, ESTER TERESA (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:ESTER
Middle Name:TERESA
Last Name:PULLIAM
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1637 ATHENS HWY
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-1768
Mailing Address - Country:US
Mailing Address - Phone:678-344-8268
Mailing Address - Fax:
Practice Address - Street 1:1637 ATHENS HWY
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:GA
Practice Address - Zip Code:30017-1768
Practice Address - Country:US
Practice Address - Phone:678-344-8268
Practice Address - Fax:888-627-6444
Is Sole Proprietor?:No
Enumeration Date:2012-11-04
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2735972363LP0808X
GARN225081363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health