Provider Demographics
NPI:1871610550
Name:VULLO, ANTONIA TOMEI (RN)
Entity type:Individual
Prefix:
First Name:ANTONIA
Middle Name:TOMEI
Last Name:VULLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 422444
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-9444
Mailing Address - Country:US
Mailing Address - Phone:770-650-8112
Mailing Address - Fax:
Practice Address - Street 1:8737 DUNWOODY PL
Practice Address - Street 2:STE 4
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-2985
Practice Address - Country:US
Practice Address - Phone:770-650-8112
Practice Address - Fax:770-650-8505
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN087437163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse