Sandra B. Pulaski, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R137019 Issued in GA

Practice address

2550 Windy Hill Rd SE
Suite 115
Marietta, GA 30067-8665

Phone

(770) 980-1818

Fax

(770) 980-1873

NPI assigned

Apr 26, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Other names 1

• Miss Sandra Jean Brubaker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1578520557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "494 MAXWELL RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300753726",
            "telephone_number": "770-883-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 WINDY HILL RD SE",
            "address_2": "SUITE 115",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678665",
            "telephone_number": "770-980-1818",
            "fax_number": "770-980-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULASKI",
        "first_name": "SANDRA",
        "middle_name": "B.",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "GA",
            "license": "R137019",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "2045242",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "R137019",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "2045242",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "R137019",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "2045242",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "BRUBAKER",
            "middle_name": "JEAN",
            "prefix": "MISS",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Adult Health Nurse Practitioner in Marietta, GA
• Providers in Marietta, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.