Most Relevant Information
Provider Data
| NPI Number: | 1003523846 |
| Provider Name: | GAELLE MAVILUKA BULABULA |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 71013415A |
Most Important Dates
| Enumeration Date: | 11/01/2022 |
| Last Updated: | 10/17/2024 |
Provider Practice Location
13090 PETIGRU DR
CARMEL
IN
460324436
Practice Location Phone/Fax
| Phone: | 3177338608 |
| Fax: |
Provider Mailing Location
2620 ELM HILL PIKE
NASHVILLE
TN
372143108
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |