Gullicksen, Laura A
Gullicksen, Laura A is an individual health care provider with primary practice located at 6325 W Johns Xing , Johns Creek GA 30097-5746. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Gullicksen, Laura A can be contacted via phone (404) 778-8311.Contact Information
Primary practice address
6325 W Johns Xing
Johns Creek GA 30097-5746
Phone: (404) 778-8311
Fax: (770) 495-1585
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | RN144532 | Georgia |
Profile Details
| NPI number | 1356523161 |
|---|---|
| LBN Legal business name | Gullicksen, Laura A |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 4th, 2007 |
| Last updated | Sep 12th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356523161 | NPPES |
| Georgia | MEDICAID | 00834094A |
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